Aspirin inhibits the formation of thromboxane A2, a potent stimulator of platelet aggregation, and is the first-line therapy for AMI. P2Y12 receptor inhibitors have incremental benefits to aspirin, and patients with acute MI who are treated with P2Y12 receptor inhibitor at discharge have improved cardiovascular outcomes (predominantly, lower recurrent MI events).11,12 Clinical Recommendation(s) 2013 ACCF/AHA Guideline for the Management of Patients With ST-Elevation Myocardial Infarction12 inhibitor therapy should be given for 1 year to patients with STEMI who receive a stent (bare-metal or drug-eluting) during primary PCI using the following maintenance doses: a. Clopidogrel 75 mg daily115,116 (Class I, Level of Evidence: B); or b. Prasugrel 10 mg daily115 (Class I, Level of Evidence: B); or c. Ticagrelor 90 mg twice a day*117 (Class I, Level of Evidence: B) *The recommended maintenance dose of aspirin to be used with ticagrelor is 81 mg daily. 2. Prasugrel should not be administered to patients with a history of prior stroke or transient ischemic attack.116 (Class III, Level of Evidence: B) 3. Aspirin should be continued indefinitely30,37,38 (Class I, Level of Evidence: A) and clopidogrel (75 mg daily) should be continued for at least 14 days30,37,38 (Class I, Level of Evidence: A) and up to 1 year (Class I, Level of Evidence: C) in patients with STEMI who receive fibrinolytic therapy. 4. Clopidogrel should be provided as follows: a. A 300-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 within 24 hours of receiving fibrinolytic therapy (Class I, Level of Evidence: C); b. 