In patients with NSTEMI (Non-ST-elevation myocardial infarction), pretreatment with prasugrel has been shown to be associated with increased bleeding risk and confers no benefit on ischemic outcomes (4). Thus, there are indications that the addition of oral P2Y12 inhibitor can await the coronary angiography, thereby minimizing the risk of excessive platelet inhibition in patients with a high bleeding risk or a potentially lethal differential diagnosis such as aortic dissection (5). Previous studies document that approximately 15% of patients with suspected STEMI have a final diagnosis other than an acute coronary syndrome (6). There is a fine balance between the benefit and possible deleterious effects of early, aggressive oral platelet inhibition in patients with suspected STEMI.