Prasugrel

60 mg × 1 at PCI → 10 mg qd (consider 5 mg/d if <60 kg) Wait 7 d prior to surgery Contraindicated if h/o TIA/CVA; caution if >75 y More rapid and potent plt inhib c/w clopi 19% ↓ CVD/MI/stroke in ACS w/ planned PCI vs. clopi, but ↑ bleeding (NEJM 2007;359:2001), incl fatal bleeds In NSTE-ACS, should be given at time of PCI and not upstream due to ↑ bleeding (NEJM 2013;369:999) ? ↓ MACE vs ticagrelor (NEJM 2019;381:1524)