What is the recommended duration of triple antithrombotic therapy with a vitamin K antagonist, aspirin, and a P2Y12 receptor inhibitor in patients with NSTE-ACS?
The duration of triple antithrombotic therapy with a vitamin K antagonist, aspirin, and a P2Y12 receptor inhibitor in patients with NSTE-ACS should be minimized to the extent possible to limit the risk of bleeding (Level of Evidence: C). Proton pump inhibitors should also be prescribed in patients with NSTE-ACS with a history of gastrointestinal bleeding who require triple antithrombotic therapy (Level of Evidence: C). Targeting oral anticoagulant therapy to a lower international normalized ratio (INR) (eg, 2.0 to 2.5) may also be reasonable in patients with NSTE-ACS managed with aspirin and a P2Y12 inhibitor (Level of Evidence: C). 