In reply: Forge quotes the recommendation from the United States guidelines to consider conservative treatment after initial stabilisation of non-ST-elevation myocardial infarction.1 This may not the best option for patients in Australian regional hospital conditions. This pathway delivers less optimal outcomes1,2 and should only be considered if a seamless switch to an invasive approach can be made. The primary recommendation from the US guidelines for patients whose conditions are initially stabilised is that “an early invasive strategy . . . is indicated”.1
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