What the guidelines say

According to the latest ESC guidelines for the treatment of acute coronary syndrome (ACS) patients (1) treatment recommendations are as follows:

Aspirin (acetylsalicylic acid) is recommended for all ACS patients without contraindications. The initial oral loading dose (LD) is 150–300 mg in aspirin-naive patients, the maintenance dose (MD) is 75–100 mg/day. Aspirin is usually combined with a P2Y12-inhibitor, whereby prasugrel (60 mg LD or ticagrelor are preferred over clopidogrel unless these stronger antiplatelet agents are not available or contraindications exist. The recommended duration for dual antiplatelet therapy (DAPT) after ACS is 12 months, independent of the initial treatment strategy, which is either conservative medical treatment only, percutaneous coronary intervention (PCI), or bypass surgery, respectively. (1, 2)

Key Words: clopidogrel, prasugrel, ticagrelor, dual antiplatelet therapy

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