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Monitoring
Follow-up is focused on the patient's individual profile and level of risk. Low- and intermediate-risk medically treated patients and revascularized patients may have a follow-up appointment in 2 to 6 weeks, while high- and very high-risk patients may follow up in 1 to 2 weeks. This provides an opportunity to check and manage adverse reactions from treatment as well as treatment adherence, optimize control of risk factors and achievement of treatment goals, monitor lifestyle modifications, reinforce the importance of continuing secondary preventive measures, and educate about the disease. A fasting lipid profile is recommended 4 to 8 weeks after starting or modifying the dose of the lipid-lowering therapy. Referral to cardiac rehabilitation is considered to improve functional status and quality of life. Outpatient evaluation of low-risk NSTE-ACS patients may include echocardiography for assessment of LV function, stress echocardiography (treadmill or pharmacological stress), treadmill stress test, cardiac MRI (stress MRI for ischemia and perfusion MRI for viability), and nuclear perfusion study. Patients with significant demonstrable ischemia should be referred for coronary angiography for potential revascularization.