Following new definition of myocardial infarction the new concept of acute coronary syndromes (ACS) and NSTEACS (non-ST elevation ACS) was established. In the contrary to patients with STEMI (ST elevation myocardial infarction) patients with NSTEMI (non-ST elevation MI) are the older, more differential group and need more individual approach. A large progress in understanding and treatment of acute coronary syndromes occurred in a last few years in cardiology. Due to results of randomized clinical trials comparing strategies of ACS treatment and multicenter registries monitoring outcomes and implementation of experts guidelines, our approach to NSTEACS still changes. Nowadays more and more data point to need for quick angiographic diagnostics and prompt revascularization not only in case of STEMI, but also in patients with NSTEMI.