Should Patients with Prior Coronary Artery Bypass Grafting Who Present with Non–ST-Elevation Acute Coronary Syndromes Undergo Routine Invasive Angiography?

AbstractPatients who have previously undergone coronary artery bypass grafting (CABG) may present with non-ST-elevation acute coronary syndromes (NSTE-ACSs). In this setting, guidelines recommend routine invasive angiography. However, patients with CABG were often excluded from key trials that informed contemporary guidelines and invasive angiography is known to be of higher risk in these patients. In this article, the authors review the evidence and propose a trial to address the question, "Should patients with prior CABG who present with NSTE-ACSs routinely undergo invasive angiography?"