Early Aggressive Versus Initially Conservative Therapy in Elderly Patients With Non-ST-Elevation Acute Coronary Syndrome

Inclusion Criteria: * Over 74 years of age. * Have had symptoms suggestive of acute myocardial ischemia at rest within 48 hours prior to randomization, and ischemic ECG changes or elevated levels of biochemical markers of myocardial damage. * Provide written informed consent before randomization. Exclusion Criteria: * Secondary causes of acute myocardial ischemia. * Ongoing myocardial ischemia despite maximally titrated anti-ischemic therapy (invasive strategy recommended). * Ongoing signs of acute heart failure despite treatment (invasive strategy recommended). * Percutaneous coronary intervention or bypass surgery within 30 days prior to randomization. * A serum creatinine level greater than 2.5 mg/dL. * Active internal bleeding, history of hemorrhagic diathesis or recent transfusion of red blood cells, whole blood or platelets. * History of cerebrovascular accident within the previous month. * Known current platelet count \< 90,000 cells/mL. * Gastrointestinal or genitourinary bleeding of clinical significance within 6 weeks prior to randomization. * Concomitant severe obstructive lung disease, malignancy or neurologic deficit limiting follow-up or adherence to the study protocol. * Participation in any phase of another clinical research study involving the evaluation of another investigational drug or device within 30 days prior to randomization. * Inability to give at least verbal informed consent to the study.