Rasmussen MB, et al. - In order to define the optimal timing of coronary angiography (CAG) in high-risk patients with acute coronary syndrome without persisting ST-segment elevation (NST-ACS), researchers examined 496 patients with suspected NST-ACS in the NON-ST-Elevation Myocardial Infarction trial to compare outcomes between those randomized to acute CAG (STEMI-like approach, <2 hours, n = 245) and those randomized to medical therapy and subacute CAG (<72 hours, n = 251). A composite of all-cause mortality, reinfarction, and readmission with congestive heart failure within 1 year from randomization was assessed as the primary end point. Findings revealed no difference with regard to the composite end point of all-cause death, reinfarction, and readmission with congestive heart failure as well as mortality between an acute and subacute CAG approach in NSTE-ACS patients. However, safety, as well as the feasibility of a strategy involving the detection of NSTE-ACS patients in the prehospital phase and direct triage to an invasive center, was suggested. In addition, this strategy could facilitate early diagnosis and revascularization.