4.6.0.0 In­di­ca­tions for P2Y12 Re­cep­tor An­tag­o­nist Use

A P2Y12 re­cep­tor an­tag­o­nist in com­bi­na­tion with as­pirin should be used for at least 1 year in pa­tients fol­lowing an ACS and may have benefits be­yond this pe­ri­od. Ev­i­dence sup­ports use of ei­ther tica­grelor or clopi­do­grel if no per­cu­ta­neous coro­nary in­ter­ven­tion was per­formed and clopi­do­grel, tica­grelor, or pra­sug­rel if a per­cu­ta­neous coro­nary in­ter­ven­tion was per­formed (138). In pa­tients with di­a­betes and prior MI (1–3 years be­fore), adding tica­grelor to as­pirin significant­ly re­duces the risk of recur­rent is­chemic events in­clud­ing car­dio­vas­cu­lar and CHD death (139).