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Background and Purpose: This focused update was prompted by recent publications and late-breaking trial results presented at major meetings that affect specific recommendations in the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention. These publications and results include the 2007 ACC/AHA guidelines for unstable angina and non-ST-elevation MI (STEMI; Journal Watch Cardiology Sep 12 2007) and recent acute coronary syndromes trials, including ICTUS (Journal Watch Cardiology Oct 7 2005) and RITA-3 (Journal Watch Cardiology Oct 7 2005). The new update provides clinicians with the most current recommendations to guide their use of PCI.