What antiplatelet therapy should be given to patients with NSTE-ACS?
Non enteric-coated, chewable aspirin (162 mg to 325 mg) should be given to all patients with NSTE-ACS without contraindications as soon as possible after presentation, and a maintenance dose of aspirin (81 mg/d to 325 mg/d) should be continued indefinitely. For patients with NSTE-ACS who are unable to take aspirin, a loading dose of clopidogrel followed by a daily maintenance dose should be administered. In addition, a GP IIb/IIIa inhibitor such as eptifibatide or tirofiban may be considered as part of initial antiplatelet therapy for those with intermediate/high-risk features. It is reasonable to use ticagrelor in preference to clopidogrel for P2Y12 treatment in patients with NSTE-ACS who undergo an early invasive or ischemia-guided strategy.