A loading dose of a P2Y12 receptor inhibitor should be given as early as possible or at time of primary PCI to patients with STEMI. Options include a. (Level of Evidence: B); or (Level of Evidence: B); or (Level of Evidence: B) inhibitor therapy should be given for 1 year to patients with STEMI who receive a stent (BMS or DES) during primary PCI using the following main- tenance doses: a. Clopidogrel 75 mg daily260,262 (Level of Evidence: B); or b. Prasugrel 10 mg daily262 (Level of Evidence: B); or c. Ticagrelor 90 mg twice a day.261 (Level of Evidence: B) Class IIa 1. It is reasonable to use 81 mg of aspirin in prefer- ence to higher maintenance doses after primary (Level of Evidence: B) 2. It is reasonable to begin treatment with an intrave- nous GP IIb/IIIa receptor antagonist such as abcix- (Level of Evidence: A), high-bolus-dose (Level of Evidence: B), or double-bolus (Level of Evidence: B) at the time of primary PCI (with or without stenting or clopidogrel pretreatment) in selected patients with STEMI who are receiving unfractionated heparin (UFH). Class IIb 1. It may be reasonable to administer intravenous GP IIb/IIIa receptor antagonist in the precatheteriza- tion laboratory setting (eg, ambulance, ED) to pa- tients with STEMI for whom primary PCI is intend- (Level of Evidence: B) 2. It may be reasonable to administer intracoronary ab- ciximab to patients with STEMI undergoing primary (Level of Evidence: B) 3. Continuation of a P2Y12 inhibitor beyond 1 year may be considered in patients undergoing DES place- ment. (Level of Evidence: C) Class III: Harm 1. 