(Section 5.1.4.1 and Table 7) 81 mg daily is the preferred daily maintenance dose IIa B 253, 259, 263, 264 receptor inhibitors Loading doses For patients who received a loading dose of clopidogrel with fibrinolytic therapy: Continue clopidogrel 75 mg daily without an additional loading dose I C 260, 262, 330, 331 For patients who have not received a loading dose of clopidogrel: If PCI is performed 24 h after fibrinolytic therapy: clopidogrel 300-mg loading dose before or at the time of PCI I C N/A If PCI is performed >24 h after fibrinolytic therapy: clopidogrel 600-mg loading dose before or at the time of PCI I C N/A If PCI is performed >24 h after treatment with a fibrin-specific agent or >48 h after a non fibrin-specific agent: prasugrel 60 mg at the time of PCI For patients with prior stroke/TIA: prasugrel III: Harm B 260 Maintenance doses and duration of therapy DES placed: Continue therapy for at least 1 y with: Prasugrel: 10 mg daily IIa B 260, 262 BMS* placed: Continue therapy for at least 30 d and up to 1 y with: Clopidogrel: 75 mg daily I C 330, 331 Prasugrel: 10 mg daily IIa B 260, 262 Anticoagulant therapy Continue UFH through PCI, administering additional IV boluses as needed to maintain therapeutic ACT depending on use of GP IIb/IIIa receptor antagonist I C N/A Continue enoxaparin through PCI: I B 332, 390 No additional drug if last dose was within previous 8 h 0.3-mg/kg IV bolus if last dose was 8 to 12 h earlier Fondaparinux: III: Harm C 304 As sole anticoagulant for PCI *Balloon angioplasty without stent placement may be used in selected patients. It might be reasonable to provide P2Y12 inhibitor therapy to patients with STEMI undergoing balloon angioplasty after fibrinolysis alone according to the recommendations listed for BMS. 