Such data include the success of reper- fusion therapy, events that occur during the hospital course (such as hemorrhagic complications), and the findings from noninvasive and invasive testing, particularly as they relate to the assessment of LV systolic function. For example, in patients treated with fibrinolytic therapy, clinical and ECG indicators of failed reperfusion identify individuals who should undergo urgent coronary angiography with intent to In addition, the emergence of HF or signifi- cant LV systolic dysfunction is among the strongest predictors of higher-mortality risk after STEMI. Stable patients with a low risk of complications may be candidates for early discharge. Among patients with STEMI managed with fibrinolysis, it has been suggested that an uncomplicated course after 72 hours of hospitalization identi- fies a group with sufficiently low risk to enable discharge.574,575 Newby and colleagues calculated that extending the hospital stay of these patients by another day would cost $105629 per year of life saved. However, the duration of hospitalization in patients treated with reperfusion therapy may be determined by other needs, such as patient education or titration of medi- cations to optimum doses.576 Physicians and patients must individualize strategies for risk reduction, using lifestyle interventions, disease-modifying pharmacological therapies, and additional coronary revascular- ization when indicated.All patients with STEMI are considered to be at sufficiently high risk to merit interventions for second- ary prevention, including the use of cardiac rehabilitation, aspi- rin, lipid-lowering therapy, beta blockers, and ACE inhibitors Additional risk assessment should be used to guide decisions about performance of coronary angiography in patients who did not undergo an invasive evaluation as part of their initial treatment strategy and to guide consideration of interventions to reduce the risk of SCD due to arrhythmia. 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations Class I 1. 