For patients with AF and recent elective PCI, the selection of antithrombotic therapy should be on the basis of their risk of stroke as follows (Fig. 3).

6. If the patient is aged < 65 years with no CHADS₂ risk factors, we recommend an APT therapy regimen without OAC, as per Part 7, Recommendations 6-9 of the Supplementary Material (adapted from the CCS 2012 APT guidelines).
7. If the patient is aged ≥ 65 years and the CHADS₂ score ≥ 1, we suggest that clopidogrel 75 mg/d and OAC be given, without concomitant ASA, for 12 months post-PCI (Conditional Recommendation, Moderate-Quality Evidence), to be followed by OAC alone (Strong Recommendation, High-Quality Evidence).

Practical tip. Some patients who are at high risk of stent thrombosis and whose risk of major bleeding is acceptable may continue OAC with clopidogrel for longer than 12 months after ACS, whereas those at particularly high risk of major bleeding may have their clopidogrel discontinued earlier than 12 months and continue to receive only OAC.