P2Y 12 Receptor Blockers

P2Y ₁₂ RBs used alone or in combination with ASA (DAPT).

ACS, those undergoing PCI with stent placement, and pts with NSTEMI or STEMI.

Continue for 6–12 mo after insertion of drug-eluting stent (DES), and 4–6 wk after insertion of bare metal stent (BMS).

Peripheral arterial disease

AF when warfarin/coumadin is contraindicated

Ischemic cerebrovascular disease, carotid or vertebral artery dissection (3–6 mo), postcarotid endarterectomy (long term), and carotid artery stenting (DAPT for 30 d).

Plt dysfunction

Bleeding if P2Y ₁₂ RB not stopped 5 d before surgery; ASA to be continued if possible

Coronary event due to stent thrombosis after DES implantation if P2Y ₁₂ RB stoppedl risk of ST to be balanced against risk of delay to surgery

Increased bleeding intra- and postop

Surgery undertaken <30 d after BMS insertion or <6 mo after DES insertion due to increased stent thrombosis risk