The risk of TIMI major bleeding in the early eptifibatide group was 2.6% com- pared with 1.8% (P=0.02) in the delayed provisional group.295 In the GUSTO IV-ACS (Global Use of Strategies To Open Occluded Coronary Arteries IV-Acute Coronary Syndromes) trial, there was no clinical benefit of abciximab in this popu- lation; in troponin-negative patients, mortality was 8.5% com- pared with 5.8% in controls (P=0.002).288,289,296,297 Aspirin is the established first-line therapy in patients with NSTE-ACS and reduces the incidence of recurrent MI and A loading dose of non enteric-coated aspirin 162 mg to 325 mg is the initial antiplatelet therapy. The subse- quent maintenance dose is 81 mg per day to 162 mg per day; in special circumstances, a higher maintenance dose up to 325 mg daily has been used.391 The lower dose is favored and all patients treated with ticagrelor should receive only 81 mg In other countries, available low-dose aspirin for- mations may include 75 mg and 100 mg. High-dose ( 160 mg) versus low-dose (<l60 mg) aspirin is associated with increased bleeding risk in the absence of improved outcomes.298 Most NSAIDs reversibly bind to COX-1, preventing inhibition by aspirin and by COX-2 and may cause prothrombotic effects. Enteric-coated aspirin should be avoided initially because of its delayed and reduced absorption.299 See Section 5.1.2.1 for recommendations at the time of PCI. See Section 4.3.1.2 for prasugrel indications in either an early invasive or ischemia-guided strategy. The recommended maintenance dose of aspirin to be used with ticagrelor is 81 mg daily.290 Amsterdam et al 2014 AHA/ACC NSTE-ACS Guideline e365 Receptor Inhibitors receptor inhibitors are approved in the United States for treatment of ischemic myocardial disorders, including NSTE-ACS. For discontinuation before surgery, see Section 5. 