In addition, in FRISC-II, invasive management was delayed and patients with markedly positive stress tests (up to 2.9-mm exercise-induced ST depression) were randomized to noninvasive or invasive therapy.338 See Online Data Supplement 18 for additional information on comparison of early invasive strategy and ischemia-guided strategy. 4.4.4.1. Comparison of Early Versus Delayed Angiography In some studies, early angiography and coronary intervention have been more effective in reducing ischemic complications than delayed interventions, particularly in patients at high risk (defined by a GRACE score >140).139,336 A more delayed strategy is also reasonable in low- to intermediate-risk patients. The advantage of early intervention was achieved in the context of intensive back- ground antithrombotic and anti-ischemic therapy. However, this question was also assessed by a meta-analysis of 11 trials (7 RCTs Meta-analysis of the RCTs was inconclusive for a survival benefit of the early invasive strategy (OR:0.83[95%CI:0.64to1.09];P=0.180),andtherewere no sig- nificant differences in MI or major bleeding; a similar result was found with the observational studies. These data are limited by the small sample size of the individual trials, low event rates, inconsis- tency in timing of intervention, and heterogeneous patient profiles. See Online Data Supplement 19 for additional information on comparison of early versus delayed angiography. Table 8. 