Although early GP IIb/IIIa inhibitor therapy as dual antiplatelet therapy also reduced complications after PCI, supporting its continued role in patients undergoing PCI,49,53,54,56,58 these 2 most recent studies56,57 more strongly support a strategy of selective rather than routine upstream use of GP IIb/IIIa inhibitor therapy as part of triple antiplate- let therapy. Data from EARLY ACS56 highlight the potential bleeding risks of upstream use of a GP IIb/IIIa inhibitor as part of triple antiplatelet therapy. The use of a GP IIb/IIIa inhibitor should be undertaken when the risk-benefit ratio suggests a potential benefit for the patient. The use of these agents as part of triple antiplatelet therapy may therefore not be supported when there is a concern for increased bleeding risk or in non high-risk subsets such as those with a normal baseline troponin level, those without diabetes, and those aged 75 years, in whom the potential benefit may be significantly offset by the potential risk of bleeding (Tables 2 and 3). 3.3. Initial Invasive Versus Initial Conservative Strategies: Recommendations (See Table 4, and Appendixes 5 and 6 for supplemental information.) 3.3.3.1. Timing of Invasive Therapy Among initially stabilized patients with UA/NSTEMI for whom an early invasive strategy of coronary angiography is chosen, optimal timing of angiography has not been well defined. Early or immediate catheterization with revascularization of unstable coronary lesions may prevent ischemic events that would oth- erwise occur during medical therapy. Conversely, pretreatment with intensive antithrombotic therapy may diminish thrombus burden and passivate unstable plaques, improving the safety of percutaneous revascularization and reducing the risk of peripro- cedural ischemic complications. Three trials have compared different strategies of early versus delayed intervention in patients with UA/NSTEMI and form the basis of the updated recommendations in this guideline. 