The primary trial endpoint was peak troponin I value during the hospitalization period. Immediate intervention conferred no advantage with regard to the primary endpoint (median troponin I value 2.1 versus 1.7 ng/mL in the immediate and delayed intervention groups, respectively), nor was there even a trend toward improved outcome in the prespecified clinical secondary endpoint of death, MI, or urgent revascu- larization by 1 month (13.7% versus 10.2% in the immediate and delayed intervention groups, respectively; P 0.31).123 These 3 trials,107,122,123 taken together with earlier studies, do provide support for a strategy of early angiography and inter- vention to reduce ischemic complications in patients who have been selected for an initial invasive strategy, particularly among those at high risk (defined by a GRACE score 140), whereas a more delayed approach is reasonable in low- to intermediate- risk patients. The early time period in this context is consid- ered to be within the first 24 hours after hospital presentation, although there is no evidence that incremental benefit is derived by angiography and intervention performed within the first few hours of hospital admission. The advantage of early intervention was achieved in the context of intensive background antithrom- botic therapy (Table 4). 5. Late Hospital Care, Hospital Discharge, and Posthospital Discharge Care 5.2. Long-Term Medical Therapy and Secondary Prevention 5.2.1. Convalescent and Long-Term Antiplatelet Therapy: Recommendations (See Table 5 and Appendix 3 for supplemental information.) Table 4. Recommendations for Initial Invasive Versus Initial Conservative Strategies 2012 Focused Update Recommendations 2012 Comments Class I 1. An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is indicated in UA/NSTEMI patients who have refractory angina or hemodynamic or electrical instability (without serious comorbidities or contraindications to such procedures).124,125 (Level of Evidence: B) 2007 recommendation remains current. 2. 