ACC/AHA Guideline Recommendation for Duration and Choice of Antiplatelet Agent in Patients with Recent Acute Coronary Syndrome (ACS), Including STEMI Aspirin Therapy is Generally Continued Indefinitely Post-ACS.

ACC/AHA Guideline Recommendation for Duration and Choice of Antiplatelet Agent in Patients with Recent Acute Coronary Syndrome (ACS), Including STEMI Aspirin Therapy is Generally Continued Indefinitely Post-ACS. Myocardial Infarction Myocardial Infarction

«Flowchart»

Acute/recent ACS (NSTE-ACS or STEMI)

Medical therapy

Lytic (STEMI)

PCI (BMS or DES)

CABG

0 mo

6 mo

Class I: At least 12 mo clopidogrel, ticagrelor)

6 mo

Class I: At least 12 mo clopidogrel, ticagrelor)

6 mo

Class I: At least 12 mo clopidogrel, ticagrelor)

12 mo

No high risk of bleeding and no significant overt bleeding on DAPT

Class llb: >12 mo may be reasonable

Class llb:

End

6 mo

Class I: Minimum 14 days and ideally at least 12 mo (clopidogrel)

6 mo

Class I: Minimum 14 days and ideally at least 12 mo (clopidogrel)

6 mo

Class I: Minimum 14 days and ideally at least 12 mo (clopidogrel)

Class I:

0 mo

6 mo

Class I: At least 12 mo (clopidogrel, prasugrel, ticagrelor)

6 mo

Class I: At least 12 mo (clopidogrel, prasugrel, ticagrelor)

6 mo

Class I: At least 12 mo (clopidogrel, prasugrel, ticagrelor)

Class I:

6 mo

Class I: After CABG, resume P2Y₁₂ inhibitor to complete 1 yr of DAPT

6 mo

Class I: After CABG, resume P2Y₁₂ inhibitor to complete 1 yr of DAPT

6 mo

Class I: After CABG, resume P2Y₁₂ inhibitor to complete 1 yr of DAPT

Class I: ₁₂