The use of upstream GP IIb/IIIa inhibitors may be considered in high-risk UA/NSTEMI patients already receiving aspirin and a P2Y12 receptor inhibitor (clopidogrel or ticagrelor) who are selected for an invasive strategy, such as those with elevated troponin levels, diabetes, or significant ST-segment depression, and who are not otherwise at high risk for bleeding.50,51,55,56,58 (Level of Evidence: B) modified ( clopidogrel replaced with P2Y12 receptor inhibitor [clopidogrel or ticagrelor]). 4. In patients with definite UA/NSTEMI undergoing PCI as part of an early invasive strategy, the use of a loading dose of clopidogrel of 600 mg, followed by a higher maintenance dose of 150 mg daily for 6 days, then 75 mg daily may be reasonable in patients not considered at high risk for bleeding.32 (Level of Evidence: B) 2011 recommendation remains current. Class III: No Benefit 1. Abciximab should not be administered to patients in whom PCI is not planned.46,71 (Level of Evidence: A) 2007 recommendation remains current. 2. In UA/NSTEMI patients who are at low risk for ischemic events (eg, TIMI risk score 2) or at high risk of bleeding and who are already receiving aspirin and a P2Y12 receptor inhibitor, upstream GP IIb/IIIa inhibitors are not recommended.56,57,78 (Level of Evidence: B) modified ( clopidogrel replaced with P2Y12 receptor inhibitor ). Class III: Harm 1. In UA/NSTEMI patients with a prior history of stroke and/or TIA for whom PCI is planned, prasugrel* is potentially harmful as part of a dual antiplatelet therapy regimen.7 (Level of Evidence: B) 2011 recommendation remains current. *Patients weighing 60 kg have an increased exposure to the active metabolite of prasugrel and an increased risk of bleeding on a 10-mg once-daily maintenance dose. 