Anginal pain in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can present in several ways, including prolonged chest pain at rest lasting over 20 minutes, new onset chest pain classified as Canadian Cardiovascular Society class II or III, recently destabilized previously stable angina with class III characteristics, or chest pain following a myocardial infarction. The document provides recommendations on diagnosis, treatment strategies, timing of invasive procedures, and long-term management of patients presenting with NSTE-ACS.

2. Anginal pain in NSTE-ACS patients may have the following
presentations:
* Prolonged (.20 min) anginal pain at rest;
* New onset (de novo) angina (class II or III of the
Canadian Cardiovascular Society classification);
* Recent destabilization of previously stable angina with
at least Canadian Cardiovascular Society Class III angina
characteristics (crescendo angina); or
* Post-MI angina.
Clinical Presentation

3. Diagnosis

4. 0 h/3 h rule-out algorithm of non-ST-elevation acute
coronary syndromes using high-sensitivity cardiac
troponin assays

5. New: 0 h/1 h rule-in & rule-out algorithm of non-ST-
elevation acute coronary syndromes using high-
sensitivity cardiac troponin assays

6. Recommendations

8. Recommendations for anti-ischaemic
drugs in the acute phase

9. Recommendations
in DAPT

10. Recommendations
in DAPT
NEW

11. Dosing of glycoprotein IIb/IIIa inhibitors in
patients with normal and impaired renal function

12. Dosing of anticoagulants in patients with
normal and impaired renal function

13. Recommendations
for anticoagulationNEW

14. Suggested strategies to reduce bleeding risk
related to PCI
NEW

15. Antithrombotic strategies in patients with
NSTEMI and non-valvular A. Fib

16. Recommendations for combining antiplatelet
agents and anticoagulants in NSTEMI patients
requiring chronic oral anticoagulation

20. Risk criteria mandating invasive strategy
in NSTE-ACS

21. Selection of treatment strategy and timing
according to initial risk stratification.

22. Recommendations for
perioperative
management of
antiplatelet therapy
patients requiring CABG

23. Recommendations for invasive
coronary angiography and
revascularization

26. Recommendations for
the management of
patients with heart
failure NSTEMI

27. Recommendations for long-term
management after non-ST-
elevation acute coronary
syndromes

29. To do and not to do messages
from the guidelines