Treatment
Percutaneous Coronary Intervention No Stent
ÎFor patients with CAD undergoing elective percutaneous coronary intervention (PCI) but no stent placement:
• For the first month, the ACCP suggests dual antiplatelet therapy with aspirin 75 to 325 mg daily and clopidogrel 75 mg daily over single antiplatelet therapy (2-C). Single antiplatelet therapy thereafter is recommended as per established ACCP recommendations for CAD.
Elective Bare-Metal Stent
ÎFor patients who have undergone elective PCI with placement of bare-metal stent (BMS):
• For the first month, the ACCP recommends dual antiplatelet therapy with aspirin 75 to 325 mg daily and clopidogrel 75 mg daily over single antiplatelet therapy (1-A).
• For the subsequent 11 months, the ACCP suggests dual antiplatelet therapy with combination of low-dose aspirin 75 to 100 mg daily and clopidogrel 75 mg daily over single antiplatelet therapy (2-C).
Elective Drug-Eluting Stent
ÎFor patients who have undergone elective PCI with placement of drug-eluting stent (DES):
• For the first 3 to 6 months, the ACCP recommends dual antiplatelet therapy with aspirin 75 to 325 mg daily and clopidogrel 75 mg daily over single antiplatelet therapy (1-A). Remark: Absolute minimum duration will vary based on stent type (in general, 3 months for -limus stents and 6 months for -taxel stents).
• After 3 to 6 months, the ACCP suggests continuation of dual antiplatelet therapy with low-dose aspirin 75 to 100 mg and clopidogrel 75 mg daily until the 12th month over single antiplatelet therapy (2-C).
Elective Bare-Metal Stent or Drug-Eluting Stent ÎFor patients who have undergone elective BMS or DES stent placement:
• The ACCP recommends using low-dose aspirin 75 to 100 mg daily and clopidogrel 75 mg daily alone rather than cilostazol in addition to these drugs (1-B).
• The ACCP suggests aspirin 75 to 100 mg daily and clopidogrel 75 mg daily as part of dual antiplatelet therapy rather than the use of either drug with cilostazol (1-B).
• The ACCP suggests cilostazol 100 mg twice daily as substitute for either low-dose aspirin 75 to 100 mg daily or clopidogrel 75 mg daily as part of a dual antiplatelet regimen in patients with an allergy or intolerance to either drug class (2-C).
• After 12 months, the ACCP recommends single antiplatelet therapy over continuation of dual antiplatelet therapy (1-B). Single antiplatelet therapy thereafter is recommended as per established ACCP recommendations for CAD.
• After 12 months, the ACCP recommends single antiplatelet therapy over continuation of dual antiplatelet therapy (1-B).
