It might be reasonable to provide P2Y12 inhibitor therapy to patients with STEMI undergoing balloon angioplasty after fibrinolysis alone according to the recommendations listed for BMS. (Level of Evidence: C) The recommended ACT with no planned GP IIb/IIIa receptor antagonist treatment is 250-300 s (HemoTec device) or 300-350 s (Hemochron device). ACT indicates activated clotting time; BMS, bare-metal stent; COR, Class of Recommendation; DES, drug-eluting stent; GP, glycoprotein; IV, intravenous; LOE, Level of Evidence; N/A, not available; PCI, percutaneous coronary intervention; TIA, transient ischemic attack; and UFH, unfractionated heparin. O Gara et al 2013 ACCF/AHA STEMI Guideline e387 within 24 hours of receiving fibrinolytic therapy (Level of Evidence: C); b. A 600-mg loading dose should be given before or at the time of PCI to patients who did not receive a previous loading dose and who are undergoing PCI more than 24 hours after receiving fibrinolytic therapy (Level of Evidence: C); and c. A dose of 75 mg daily should be given after (Level of Evidence: C) Class IIa 1. After PCI, it is reasonable to use 81 mg of aspirin per day in preference to higher maintenance dos- (Level of Evidence: B) 2. Prasugrel, in a 60-mg loading dose, is reasonable once the coronary anatomy is known in patients who did not receive a previous loading dose of clopidogrel at the time of administration of a fibrinolytic agent, but prasugrel should not be given sooner than 24 hours after administration of a fibrin-specific agent or 48 hours after administration of a non fibrin-specific (Level of Evidence: B) 3. Prasugrel, in a 10-mg daily maintenance dose, is rea- sonable after PCI.260,262 (Level of Evidence: B) Class III: Harm 1. 