Noninvasive stress testing is recommended in low- and intermediate-risk patients who have been free of ischemia at rest or with low-level activity for a mini- (Level of Evidence: B) 2. Treadmill exercise testing is useful in patients able to exercise in whom the ECG is free of resting ST changes that may interfere with interpretation.349 352 (Level of Evidence: C) 3. Stress testing with an imaging modality should be used in patients who are able to exercise but have ST changes on resting ECG that may interfere with in- terpretation. In patients undergoing a low-level ex- ercise test, an imaging modality can add prognostic (Level of Evidence: B) 4. Pharmacological stress testing with imaging is rec- ommended when physical limitations preclude ad- equate exercise stress. (Level of Evidence: C) 5. A noninvasive imaging test is recommended to evalu- ate LV function in patients with definite ACS.349 352 (Level of Evidence: C) The management of patients with NSTE-ACS requires con- tinuous risk stratification. Important prognostic information is derived from initial assessment, the patient s course during the early days of management, and the response to anti-ischemic and antithrombotic therapy. The choice of stress test is based on the patient s resting ECG and ability to exercise, local expertise, and available technologies. The exercise intensity of the treadmill test (low level or symptom-limited) is used at the discretion of the attending clinician based on individ- ual patient assessment. For invasively managed patients with residual nonculprit lesions, additional evaluation may be indi- cated to ascertain the significance of such lesions. Refer to the PCI CPG for additional details.26 4.5.1. 