An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended in patients with extensive comorbidities (eg, liver or pulmonary failure, cancer), in whom the risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization. (Level of Evidence: C) 2007 recommendation remains current. 2. An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended in patients with acute chest pain and a low likelihood of ACS. (Level of Evidence: C) 2007 recommendation remains current. 3. An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) should not be performed in patients who will not consent to revascularization regardless of the findings. (Level of Evidence: C) 2007 recommendation remains current. *Immediate catheterization/angiography is recommended for unstable patients. ACS indicates acute coronary syndrome; and UA/NSTEMI, unstable angina/non ST-elevation myocardial infarction. Table 5. Recommendations for Convalescent and Long-Term Antiplatelet Therapy 2012 Focused Update Recommendations 2012 Comments Class I 1. For UA/NSTEMI patients treated medically without stenting, aspirin* should be prescribed indefinitely60,61,63,64 (Level of Evidence: A); clopidogrel (75 mg per day) or ticagrelor (90 mg twice daily) should be prescribed for up to 12 months.9,10,14 (Level of Evidence: B) modified (included ticagrelor and footnote added pertaining to recommended aspirin maintenance dose). 2. For UA/NSTEMI patients treated with a stent (BMS or DES), aspirin should be continued indefinitely. (Level of Evidence: A) The duration and maintenance dose of P2Y12 receptor inhibitor therapy should be as follows: modified (included the term P2Y12 receptor inhibitor and altered aspirin dosing and duration of therapy after stent deployment). 