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Aspirin and Oral P2Y12 Inhibitors in Patients Undergoing PCI
COR LOE
Recommendations
1 B-R 1. In patients undergoing PCI, a loading dose of aspirin, followed
by daily dosing, is recommended to reduce ischemic events.*
1 B-R 2. In patients with ACS undergoing PCI, a loading dose of
P2Y12 inhibitor, followed by daily dosing, is recommended to
reduce ischemic events.
1 C-LD 3. In patients with SIHD undergoing PCI, a loading dose of
clopidogrel, followed by daily dosing, is recommended to
reduce ischemic events.
1 C-LD 4. In patients undergoing PCI within 24 hours after fibrinolytic
therapy, a loading dose of 300 mg of clopidogrel, followed by
daily dosing, is recommended to reduce ischemic events.
2a B-R 5. In patients with ACS undergoing PCI, it is reasonable to use
ticagrelor or prasugrel in preference to clopidogrel to reduce
ischemic events, including stent thrombosis.
2b B-R 6. In patients <75 years of age undergoing PCI within 24 hours
after fibrinolytic therapy, ticagrelor may be a reasonable
alternative to clopidogrel to reduce ischemic events.
3: Harm B-R 7. In patients undergoing PCI who have a history of stroke
or transient ischemic attack, prasugrel should NOT be
administered.
* Contraindications to ticagrelor: previous intracranial hemorrhage or ongoing bleeding.
Contraindications to prasugrel: previous intracranial hemorrhage, previous ischemic stroke
or transient ischemic attack, or ongoing bleeding. Prasugrel should be used with caution at a
lower dose in patients ≥75 years of age or with a body weight <60 kg.
Pharmacotherapy in Patients Undergoing PCI
