Continuation of DAPT beyond 12 months may be considered in patients undergoing stent implanta- tion. (Level of Evidence: C) Class III: Harm 1. Prasugrel should not be administered to patients with a prior history of stroke or transient ischemic (Level of Evidence: B) Comprehensive recommendations on the use of antiplatelet and anticoagulant therapy in patients with NSTE-ACS under- going PCI are given in the 2011 PCI CPG.26 Aspirin reduces the frequency of ischemic complications after PCI and is ideally administered at least 2 hours, and preferably 24 hours, before DAPT, consisting of aspirin and a P2Y12 inhibitor, in patients treated with coronary stents reduces the risk of stent thrombosis and composite ischemic events.296,331,372 375,389,390 Compared with a loading dose of 300 mg of clopidogrel, a load- ing dose of 600 mg of clopidogrel in patients undergoing PCI achieves greater platelet inhibition with fewer low responders and decreases the incidence of MACE.376 378 In patients with ACS who have undergone coronary stenting, treatment with prasugrel or ticagrelor, compared with treatment with clopi- dogrel, results in a greater reduction in composite ischemic events and the incidence of stent thrombosis, although at a risk of increased non CABG bleeding.293,302 The optimal dura- tion of DAPT therapy in patients treated with DES is not well However, aspirin is continued indefinitely in all patients managed with a bare-metal stent or DES, and DAPT is an option for >12 months in patients who have received a DES. This determination should balance the risks of stent thrombo- sis and ischemic complications versus bleeding and should be jointly made by the clinician and the patient. 