This protocol addresses patients presenting with a working diagnosis of NSTE-ACS and a high index of clinical suspicion for unstable angina, who do not fulfil very high-risk or high-risk NSTE-ACS criteria. Current evidence specifically recommends an inpatient invasive strategy for this population.
The management strategy centres on an inpatient invasive approach — coronary angiography during hospital admission — combined with antiplatelet and parenteral anticoagulation therapies initiated at the time of diagnosis. The complete agent selection, sequencing, supportive measures, and decision points are detailed in the full structured protocol.
DOI: 10.1093/eurheartj/ehad191
An invasive strategy during hospital admission is recommended in NSTE-ACS patients with high-risk criteria or a high index of suspicion for unstable angina.
For patients with a high index of suspicion for UA, an inpatient invasive strategy is recommended.
Parenteral anticoagulation is recommended for all patients with ACS at the time of diagnosis.
In all ACS patients, a P2Y12 receptor inhibitor is recommended in addition to aspirin, given as an initial oral LD followed by an MD for 12 months unless there is HBRc.
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