Consideration should be given to the potential and as yet undetermined risk of intracranial hemorrhage in patients with prior stroke or TIA. Applies to patients who were not treated chronically with these medications. BMS indicates bare-metal stent; CABG, coronary artery bypass graft; DES, drug-eluting stent; GI, gastrointestinal; GP, glycoprotein; IV, intravenous; PCI, percutaneous coronary intervention; TIA, transient ischemic attack; TIMI, Thrombolysis In Myocardial Infarction; and UA/NSTEMI, unstable angina/non ST-elevation myocardial infarction. Jneid et al 2012 UA/NSTEMI Focused Update 887 Table 3. Recommendations for Additional Management of Antiplatelets and Anticoagulants 2012 Focused Update Recommendations 2012 Comments Class I 1. For UA/NSTEMI patients in whom an initial conservative strategy is selected and no subsequent features appear that would necessitate diagnostic angiography (recurrent symptoms/ischemia, heart failure, or serious arrhythmias), a stress test should be performed.72 (Level of Evidence: B) modified (included ticagrelor, and duration of antiplatelet therapy changed to up to 12 months ). a. If, after stress testing, the patient is classified as not at low risk, diagnostic angiography should be performed.55,72 (Level of Evidence: A) b. If, after stress testing, the patient is classified as being at low risk, the instructions noted below should be followed in preparation for discharge55,72: 1. Continue aspirin indefinitely.61,63,64 (Level of Evidence: A) 2. Continue clopidogrel or ticagrelor* for up to 12 months.9,10,13 (Level of Evidence: B) 3. Discontinue IV GP IIb/IIIa inhibitor if started previously.50,51 (Level of Evidence: A) 4. Continue UFH for 48 hours66,79 (Level of Evidence: A) or administer enoxaparin80 82 (Level of Evidence: A) or fondaparinux83 (Level of Evidence: B) for the duration of hospitalization, up to 8 days, and then discontinue anticoagulant therapy. 2. For UA/NSTEMI patients in whom CABG is selected as a postangiography management strategy, the instructions noted below should be followed. 2011 recommendation remains current. a. 