ACS indicates acute coronary syndromes; BMS, bare-metal stent(s); COR, class of recommendation; DAPT, dual antiplatelet therapy; DES, drug-eluting stent(s); GI, gastrointestinal; HDL, high-density lipoprotein; LDL, low-density lipoprotein; LOE, level of evidence; N/A, not applicable; NSAID, nonsteroidal anti-inflammatory drug; PCI, percutaneous coronary intervention; and PPI, proton pump inhibitor. Class IIa 1. After PCI, it is reasonable to use aspirin 81 mg per day in preference to higher maintenance dos- es.302,573 576 (Level of Evidence: B) 2. If the risk of morbidity from bleeding outweighs the anticipated benefit afforded by a recommended du- ration of P2Y12 inhibitor therapy after stent implan- tation, earlier discontinuation (eg, <12 months) of P2Y12 inhibitor therapy is reasonable. (Level of Evidence: C) Class IIb 1. Continuation of clopidogrel, prasugrel, or ticagrelor beyond 12 months may be considered in patients undergoing placement of DES.567,568 (Level of Evi- dence: C) Continued treatment with the combination of aspirin and a P2Y12 inhibitor antagonist after PCI appears to reduce MACE.570,572 On the basis of RCT protocols, secondary prevention measures, and expert consensus opinion, aspirin 81 mg daily should be given indefinitely after PCI. Likewise, P2Y12 inhibitors should be given for a minimum of 1 month after BMS (minimum 2 weeks for patients at significant increased risk of bleeding)580 and for 12 months after DES and ideally in all patients who are not at high risk of bleeding. The 2009 STEMI/PCI guidelines update10 listed the rec- ommendation if the risk of morbidity because of bleeding outweighs the anticipated benefit afforded by thienopyridine therapy, earlier discontinuation should be considered as a Class I recommendation, although the language used, in part, was consistent with a Class IIa recommendation. 