Badings EA, et al. - As per recommendations, high-risk patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) should receive an early invasive strategy (EIS), defined as coronary angiography (CAG), within 24 h of admission, researchers investigated guideline adherence, patient characteristics associated with timing of the intervention and clinical outcome. From a prospective registry, the use and timing of CAG and the characteristics and clinical outcome associated with timing were evaluated in 2,299 high-risk NSTE-ACS patients from 2006 and 2014. Outcomes revealed an increase in the percentage of high-risk NSTE-ACS patients undergoing CAG and EIS in the last decade. In contrast to the guidelines, EIS was less frequently provided to patients with a higher risk profile. However, after multivariate adjustment for this higher risk, there appeared no difference in outcome after 30 days and 1 year.