For invasively managed patients with residual nonculprit lesions, additional evaluation may be indi- cated to ascertain the significance of such lesions. Refer to the PCI CPG for additional details.26 4.5.1. Noninvasive Test Selection The goals of noninvasive testing in patients with a low or intermediate likelihood of CAD and high-risk patients who did not have an early invasive strategy are to detect ischemia and estimate prognosis. This information guides further diag- nostic steps and therapeutic measures. Because of its simplicity, lower cost, and widespread famil- iarity with its performance and interpretation, the standard low- level exercise electrocardiographic stress test remains the most reasonable test in patients who are able to exercise and who have a resting ECG that is interpretable for ST shifts. There is evidence that imaging studies are superior to exercise elec- trocardiographic evaluation in women for diagnosis of CAD.350 However, for prognostic assessment in women, treadmill exer- cise testing has provided comparable results to stress imag- Patients with an electrocardiographic pattern that would interfere with interpretation of the ST segment (baseline ST abnormalities, bundle-branch block, LV hypertrophy with ST-T changes, intraventricular conduction defect, paced rhythm, pre-excitation, and digoxin) should have an exercise test with imaging. Patients who are unable to exercise should have a pharmacological stress test with imaging. Low- and intermedi- ate-risk patients with NSTE-ACS may undergo symptom-lim- ited stress testing, provided they have been asymptomatic and clinically stable at 12 to 24 hours for those with UA and 2 to 5 days for patients at similar risk with NSTEMI.349 The optimal testing strategy in women is less well defined than in men. 4.5.2. Selection for Coronary Angiography In contrast to noninvasive tests, coronary angiography provides detailed structural information for assessment of prognosis and appropriate management. 