Myocardial revascularization is reasonable in preg- nant women with NSTE-ACS if an ischemia-guided strategy is ineffective for management of life- (Level of Evidence: C) Class III: No Benefit 1. Women with NSTE-ACS and low-risk features (see Section 3.3.1) should not undergo early invasive treatment because of the lack of benefit141,345,346 and the possibility of harm.141 (Level of Evidence: B) Women of all ages have higher rates of in-hospital and long- term complications of NSTE-ACS than men, including bleed- ing, HF, cardiogenic shock, acute renal failure, recurrent MI, stroke, and readmissions.670,675,676 Women present later after symptom onset of NSTE-ACS and have higher rates of inappropriate discharges from the Women more commonly report atypical symp- toms than men.675,679 Women presenting with chest pain are more likely than men to have either a noncardiac cause or cardiac causes other than obstructive epicardial coronary dis- Women with NSTE-ACS with no apparent obstructive epicardial disease have a 2% risk of death or MI within 30 days and require secondary prevention and symp- Women derive the same treatment benefit as men from aspi- rin, clopidogrel, anticoagulants, beta blockers, ACE inhibi- tors, and statins.385,670 672,675,676,683,684 Despite worse outcomes, women with NSTE-ACS are underprescribed guideline- directed pharmacological therapy, both during the acute ill- ness and at discharge.538,685,686 The basis for pharmacotherapy for women with NSTE-ACS with abnormal biomarkers and/ or functional tests, but without significant obstructive epicar- dial disease, remains unclear (Section 7.13). In addition to risk factor modification, some studies support the benefit of imipramine, ranolazine, beta blockers, and/or ACE inhibitors to reduce adverse outcomes.687 Women with NSTE-ACS incur a higher rate of bleeding complications672,673 (Section 7.8) and renal failure. 