An unmet need is to more clearly distinguish which older patients are candidates for an ischemia-guided strategy compared with an early invasive management strategy.An appreciable number of patients with NSTE-ACS have angiographically normal or nonobstructive CAD, a group in which women predominate. Their prognosis is not benign, and the multiple mechanisms of ACS postulated for these patients remain largely speculative. Clinical advances are predicated on clarification of the patho- physiology of this challenging syndrome. A fundamental aspect of all CPGs is that these carefully developed, evidence-based documents cannot encompass all clinical circumstances, nor can they replace the judgment of individual physicians in management of each patient. The sci- ence of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This CPG has adhered to these principles for optimal management of patients with NSTE-ACS. Presidents and Staff American College of Cardiology Patrick O Gara, MD, FACC, President Shalom Jacobovitz, Chief Executive Officer William J. Oetgen, MD, MBA, FACC, Executive Vice President, Science, Education, and Quality Amelia Scholtz, PhD, Publications Manager, Clinical Policy and Pathways American College of Cardiology/American Heart Association Lisa Bradfield, CAE, Director, Science and Clinical Policy Emily Cottrell, MA, Quality Assurance Specialist, Science and Clinical Policy Alexa Papaila, Specialist, Science and Clinical Policy American Heart Association Elliot Antman, MD, FAHA, President Nancy Brown, Chief Executive Officer Rose Marie Robertson, MD, FAHA, Chief Science Officer Gayle R. Whitman, PhD, RN, FAHA, FAAN, Senior Vice President, Office of Science Operations Marco Di Buono, PhD, Vice President, Science, Research, and Professional Education, Office of Science Operations Jody Hundley, Production Manager, Scientific Publications, Office of Science Operations References 1. Committee on Standards for Developing Trustworthy Clinical Practice Guidelines; Institute of Medicine. Clinical Practice Guidelines We Can Trust. 