Some have suggested that the loading and maintenance doses of clopidogrel should be altered to account for potential reduced responsiveness to clopidogrel therapy or that some subgroups of high-risk patients should be treated preferentially with prasugrel.20 Accordingly, the optimal loading and short-term maintenance dosing for clopidogrel in patients with UA/NSTEMI undergoing PCI is uncertain. Loading and short-term maintenance doses of clopidogrel were studied in CURRENT OASIS 7 (Clopidogrel optimal loading dose Usage to Reduce Recurrent Events Organiza- tion to Assess Strategies in Ischemic Syndromes), with published data demonstrating a potential benefit of higher- dose clopidogrel in patients with definite UA/NSTEMI undergoing an invasive management strategy.32,33 The CURRENT OASIS 7 trial randomized 25 086 patients with ACS who were intended for PCI and who were not consid- ered to be at high risk for bleeding to receive higher-dose clopidogrel (600 mg loading, 150 mg daily for 6 days, 75 mg daily thereafter) versus standard-dose clopidogrel (300 mg loading, 75 mg daily) as part of a 2 2 design that also compared maintenance higher-dose aspirin (300 to 325 mg daily) with low-dose aspirin (75 to 100 mg daily). All patients received 300 mg of aspirin on Day 1 regardless of random- ization after Day 1. The primary endpoint of the trial was the combination of cardiovascular death, myocardial (re)infarc- tion, or stroke at 30 days. Although the overall trial33 failed to demonstrate a significant difference in the primary endpoint between the clopidogrel and aspirin groups (4.2% versus 4.4%), the PCI subset (n 17 263) did show significant differences in the clopidogrel arm.32 The primary outcome was reduced in the PCI subgroup randomized to higher-dose clopidogrel (3.9% versus 4.5%; P 0.035), and this was largely driven by a reduction in myocardial (re)infarction (2.0% versus 2.6%; P 0.017). 