Clinical recommendation	Evidence rating	References
The recommended dosages for dual antiplatelet therapy are 162 to 325 mg of aspirin daily and 75 mg of clopidogrel (Plavix) or 10 mg of prasugrel (Effient) daily, but ticlopidine (formerly Ticlid) in a dosage of 250 mg twice daily may be used if the patient cannot tolerate clopidogrel or prasugrel.	C	14, 19, 30, 31
The preferred duration of dual antiplatelet therapy after bare-metal or drug-eluting stent placement is one year.	C	19, 30, 31
The minimum recommended duration of dual antiplatelet therapy after stent placement is one month for bare-metal stents, three months for the sirolimus (Rapamune)-eluting stent (Cypher), and six months for other drug-eluting stents. In special circumstances, two weeks of therapy after bare-metal stent placement may be considered.	C	11, 14, 19, 30,31
Patients at increased risk of gastrointestinal bleeding should receive acid suppression therapy while receiving dual antiplatelet therapy. Proton pump inhibitors may interfere with clopidogrel metabolism, but data are conflicting so an H2-receptor blocker or antacids may be preferable.	C	32–35
After the recommended duration of treatment with dual antiplatelet therapy, aspirin (75 to 162 mg daily) should be continued indefinitely.	C	19, 31
Following stent placement, elective surgery should be delayed until the recommended course of dual antiplatelet therapy is completed. If surgery cannot be delayed, it should be performed while the patient is on dual antiplatelet therapy. If that is not feasible, the thienopyridine should be stopped for the shortest time possible and then restarted.	C	19, 32, 39