Information more relevant to contemporary practice pat- terns was provided in the 2009 publication of the large-scale multicenter TIMACS (Timing of Intervention in Acute Cor- onary Syndromes) trial,107 which compared early versus delayed angiography and intervention in patients with non Jneid et al 2012 UA/NSTEMI Focused Update 885 Table 2. Recommendations for Antiplatelet Therapy 2012 Focused Update Recommendations 2012 Comments Class I 1. Aspirin should be administered to UA/NSTEMI patients as soon as possible after hospital presentation and continued indefinitely in patients who tolerate it.59 66 (Level of Evidence: A) 2011 recommendation remains current. 2. A loading dose followed by daily maintenance dose of either clopidogrel13,67,68 (Level of Evidence: B), prasugrel* (in PCI-treated patients)7 (Level of Evidence: C), or ticagrelor 9 (Level of Evidence: C) should be administered to UA/NSTEMI patients who are unable to take aspirin because of hypersensitivity or major GI intolerance. modified (included prasugrel and ticagrelor). 3. Patients with definite UA/NSTEMI at medium or high risk and in whom an initial invasive strategy is selected (Appendix 6) should receive dual antiplatelet therapy on presentation.13,16,45,69 (Level of Evidence: A) Aspirin should be initiated on presentation.59,61 66 (Level of Evidence: A) The choice of a second antiplatelet therapy to be added to aspirin on presentation includes 1 of the following (note that there are no data for therapy with 2 concurrent P2Y12 receptor inhibitors, and this is not recommended in the case of aspirin allergy): modified (included ticagrelor). 