Early or Delayed Revascularization for Intermediate and High-risk Non ST-elevation Acute Coronary Syndromes?

Inclusion Criteria: * Must not be of child-bearing potential (1 year post-menopausal, contraceptive use or surgically sterile); * Subject with a non-ST-segment elevation ACS defined by the presence of at least 2 of the following criteria: symptoms of myocardial ischemia, electrocardiographic ST-segment abnormalities (depression or transient elevation of at least 0.1 mV) or T-wave inversion in at least in 2 contiguous leads, or an elevated cardiac troponin value (above the upper limit of normal) ; * Subject requiring intervention according to physician's judgment including the following criteria subject with one of the following risk factor defining intermediate and high risk ACS: diabetes mellitus, kidney failure, reduced LVEF, early post infarction angina, recent PCI, prior CABG or a GRACE risk score \>109, recurrent symptoms or ischaemia on non-invasive testing (2); * Must be enrolled at a cardiac catheterization laboratory hospital or at a hospital/ambulance service affiliated with a cardiac catheterization laboratory hospital; Exclusion Criteria: * \- Minors or pregnant or breast-feeding women; * Subject with low risk ACS; * Subject with very high-risk ACS: refractory angina, severe heart failure, life-threatening ventricular arrhythmias, hemodynamic instability requiring immediate intervention; * Subject with thrombolytic therapy during the preceding 24 hours; * Subject with bleeding diathesis; * Subject with Upstream treatment by a GPIIb/IIIa inhibitor; * Subject under chronic anticoagulant; * Subject participating in another research protocol; * Subject not agreeing to participate; * Subject with contraindication to or under chronic P2Y12 receptor antagonists therapy (clopidogrel, ticagrelor and prasugrel); * Present with ST-segment elevation myocardial infarction (STEMI) at the time of entry or randomization into the study defined as follows: * ST-segment elevation myocardial infarction is defined as a history of chest discomfort or ischemic symptoms of \>20 minutes duration at rest ≤14 days prior to entry into the study with one of the following present on at least one ECG prior to randomization: 1. ST-segment elevation ≥1 mm in two or more contiguous ECG leads. 2. New or presumably new left bundle branch block (LBBB). 3. ST-segment depression ≥1 mm in two anterior precordial leads (V1 through V4) with clinical history and evidence suggestive of true posterior infarction. * Have cardiogenic shock (systolic blood pressure \<90 mm Hg associated with clinical evidence of end-organ hypoperfusion, or subjects requiring vasopressors to maintain systolic blood pressure over 90 mm Hg and associated with clinical evidence of end-organ hypoperfusion); * Have New York Heart Association (NYHA) Class IV congestive heart failure (CHF).