Key clinical recommendationSOR labelsReferences
The updated ACC/AHA guideline recommends use of the thienopyridine clopidogrel (Plavix) in patients who cannot tolerate aspirin (ACC/AHA class I).A2, 3, 17
The updated ACC/AHA guideline considers the use of clopidogrel in addition to aspirin to have a class I indication in patients with UA/NSTEMI who are undergoing an early noninterventional or interventional approach and are not at high risk for bleeding.A2, 3, 18, 19
When elective coronary artery bypass grafting is planned, clopidogrel should be withheld for five to seven days.C2, 3
Platelet glycoprotein IIb/IIIa inhibitors have an ACC/AHA class I indication in patients for whom catheterization and percutaneous coronary intervention are planned. These agents should be administered in addition to aspirin and heparin.A2023, 25
Anticoagulation with unfractionated heparin or low-molecular-weight heparin for patients with UA/NSTEMI has an ACC/AHA class I indication. The heparin is to be used in addition to aspirin or clopidogrel.A27