After multivariable adjustment, the 1-year mortality in the overall cohort was 36% lower with early P 0.001).169 The magnitude of the difference in 1-year mortality was similar in patients with normal eGFR (early revascularization versus medically treated: 1.9% versus 10%; 95% CI: 0.52 to 0.80; P 0.001), and moderate CKD [eGFR 95% CI: 0.54 to 0.86; P 0.001). The benefit of an invasive therapy was not evident in patients with severe CKD stage 4 ] (22% versus 41%; HR: stage 5 kidney failure [eGFR 15 mL/min per 1.73 m2 or to 3.09; P 0.150). Early revascularization was associated with increased 1-year survival in UA/NSTEMI patients with mild to moderate CKD, but no association was observed in those with severe or end-stage kidney disease.169 The findings from SWEDEHEART are limited by their nonrandomized nature and the potential for selection bias despite the intricate multivariable adjustment.169 On the other hand, SWEDEHEART captured unselected patients with more comor- bidities and is therefore more reflective of real-world patients. Recently, a collaborative meta-analysis of randomized con- trolled trials that compared invasive and conservative treatments in UA/NSTEMI was conducted to estimate the effectiveness of early angiography in patients with CKD.168 The meta-analysis demonstrated that an invasive strategy was associated with a significant reduction in rehospitalization (RR: 0.76; 95% CI: 0.66 to 0.87; P 0.001) at 1 year compared with conservative strategy. The meta-analysis did not show any significant differ- ences with regard to all-cause mortality (RR: 0.76; 95% CI: 0.49 P 0.22), and the composite of death/nonfatal MI (RR: 0.79; Our recommendation is that an early invasive strategy (ie, diagnostic angiography with intent to perform revasculariza- tion) is a reasonable strategy in patients with mild and moderate CKD. 