@entity1187 ( @entity1187 ) are life-threatening manifestations of @entity453 , occurring when a @entity715 forms at the site of @entity731 or fissuring. Almost all @entity1 discharged from the hospital after an @entity1187 ( @entity583 or @entity1459 ) in the United States receive antiplatelet therapy. Current recommendations for post- @entity1187 antiplatelet therapy are @entity117 75 to 162 mg/day indefinitely for all @entity1 , plus a @entity1747 (currently @entity1397 75 mg/day) for > or = 12 months in those receiving stents unless there is a high risk of @entity548 . Dual antiplatelet therapy is indicated because @entity1 with @entity1187 have a @entity49 state which persists for at least 6 months after the acute event, and agents targeting different mechanisms have synergistic antiplatelet effects. The @entity1747 class includes @entity1396 , @entity1397 , and @entity3076 . @entity1397 is recommended in guidelines because @entity1396 carries a higher risk of adverse events including @entity1503 . @entity3076 is not yet available outside of a research setting. @entity1397 + @entity117 reduces the risk of an adverse clinical event after @entity1187 by 15% and after percutaneous coronary intervention (PCI) by 34%. However, there is considerable interpatient variability in response to @entity1397 and a mean of 21% of @entity1 (95% confidence interval [CI], 17 % - 25%) are nonresponsive to the drug as measured by platelet aggregation inhibition. Nonresponsiveness is associated with an increased risk of secondary @entity63 events. Compared with @entity1397 , the newest @entity1747 , @entity3076 , has a faster onset of platelet inhibition and less variability of response. In clinical trials, the combination of @entity3076 + @entity117 reduced the risk of a second @entity63 event by 19% compared with @entity1397 + @entity117 . There is a small increase in the risk of @entity548 with dual antiplatelet therapy, but the benefit still outweighs the risk in most @entity1 . @entity1 with a history of transient @entity63 attack or @entity64 should not receive @entity3076 + @entity117 because of increased risk of events.

The potential role of @entity3076 in secondary prevention of @entity63 events in @entity1 with XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['ACS', 'Acute coronary syndromes'] @entity3076 :: ('MESH:C408153', 'Chemical') :: ['prasugrel', 'Prasugrel'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity731 :: ('MESH:D050197', 'Disease') :: ['atherosclerotic plaque rupture'] @entity1396 :: ('MESH:D013988', 'Chemical') :: ['ticlopidine'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel', 'Clopidogrel'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity49 :: ('MESH:D019851', 'Disease') :: ['hypercoagulable'] @entity1503 :: ('MESH:D006402', 'Disease') :: ['blood dyscrasias'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['unstable angina'] @entity1747 :: ('MESH:C446540', 'Chemical') :: ['thienopyridine'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus']
@entity1187 :: (MESH:D054058,Disease) :: ['acute coronary syndromes']
