We recommend that for patients who are compliant with clopidogrel and have experienced stent thrombosis, prasugrel 10 mg daily or ticagrelor 90 mg twice daily may be considered in addition to ASA 81 mg daily (Strong, Low).

We suggest continuation of a P2Y12 inhibitor with ASA beyond 12 months be considered in patients with a high thrombosis risk and a low bleeding risk (Conditional, Low).

We suggest that if patients require surgery (CABG or non-CABG), the P2Y12 inhibitor be withheld, if possible, as follows: clopidogrel 5 days before, ticagrelor 5 days before, and prasugrel 7 days before to the date of surgery (Conditional, Low).

We suggest against switching the P2Y12 inhibitor initially selected at discharge unless there is a compelling clinical reason (e.g., stent thrombosis, bleeding, or cardiovascular event) (Conditional, Very Low).