For more on AHA statements and guidelines development, visit http://my.americanheart.org/statements and select the Policies and Development link. Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/Copyright- Permission-Guidelines_UCM_300404_Article.jsp. A link to the Copyright Permissions Request Form appears on the right side of the page. 2012 by the American College of Cardiology Foundation and the American Heart Association, Inc. Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0b013e318256f1e0 ACCF/AHA TASK FORCE MEMBERS Alice K. Jacobs, MD, FACC, FAHA, Immediate Past Chair; Jeffrey L. Anderson, MD, FACC, FAHA, Chair; Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect; Nancy M. Albert, PhD, CCNS, CCRN, FAHA; Mark A. Creager, MD, FACC, FAHA; David DeMets, PhD; Steven M. Ettinger, MD, FACC; Robert A. Guyton, MD, FACC; Judith S. Hochman, MD, FACC, FAHA; Frederick G. Kushner, MD, FACC, FAHA; E. Magnus Ohman, MD, FACC; William G. Stevenson, MD, FACC, FAHA; Clyde W. Yancy, MD, FACC, FAHA Table of Contents Preamble 876 1. Introduction 879 1.1. Methodology and Evidence Review 879 1.2. Organization of the Writing Group 879 1.3. Document Review and Approval 879 3. Early Hospital Care 879 3.2. Antiplatelet/Anticoagulant Therapy in Patients for Whom Diagnosis of UA/NSTEMI Is Likely or Definite: Recommendations 879 3.2.1. Antiplatelet Therapy: Recommendations 879 3.2.3. Additional Management of Antiplatelet and Anticoagulant Therapy: Recommendations 879 Therapy in Patients for Whom Diagnosis of UA/NSTEMI Is Likely or Definite 879 Inhibitors 879 Receptor Inhibitors for PCI in UA/NSTEMI 881 3.2.3.1.2.1. Timing of Discontinuation of P2Y12 Receptor Inhibitor Therapy for Surgical Procedures 882 Variability in Responsiveness to Clopidogrel 882 3.2.3.1.4. Optimal Loading and Maintenance Dosages of Clopidogrel 883 3.2.3.1.5. Proton Pump Inhibitors and Dual Antiplatelet Therapy for ACS 883 3.2.3.1.6. Glycoprotein IIb/IIIa Receptor Antagonists 884 3.3. 