Focused 2012 Update of the Canadian Cardiovascular Society Guidelines for the Use of Antiplatelet Therapy Jean-François Tanguay, MD, CSPQ, FRCPC, FACC,

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Focused 2012 Update of the Canadian Cardiovascular Society Guidelines for the Use of Antiplatelet Therapy Jean-François Tanguay, MD, CSPQ, FRCPC, FACC, FAHA, FESC, Alan D. Bell, MD, CCFP, Margaret L. Ackman, BSc(Pharm), PharmD, ACPR, FCSHP, Robert D.C. Bauer, MD, FRCPC, FACC, Raymond Cartier, MD, FRCPC, Wee-Shian Chan, MD, FRCPC, James Douketis, MD, FRCPC, André Roussin, MD, FRCPC, Gregory Schnell, BSP, MD, FRCPC, Subodh Verma, MD, PhD, FRCSC, Graham Wong, MD, MPH, FRCPC, FACC, Shamir R. Mehta, MD, MSc, FRCPC, FACC, FESC Canadian Journal of Cardiology Volume 29, Issue 11, Pages 1334-1345 (November 2013) DOI: 10.1016/j.cjca.2013.07.001 Copyright © 2013 Terms and Conditions

Figure 1 Recommendations for non-ST–elevation acute coronary syndrome (NSTEACS) 1. ASA, acetylsalicylic acid; CABG, coronary artery bypass grafting; CAD, coronary artery disease; MI, myocardial infarction; PCI, percutaneous coronary intervention; PLATO, Platelet Inhibition and Patient Outcomes. * Moderate to high-risk NSTEACS as defined in PLATO16: ≥ 2 of: (1) ischemic ST changes on electrocardiogram; (2) positive biomarkers; and (3) 1 of the following: 60 years of age or greater, previous MI or CABG, CAD > 50% stenosis in 2 vessels, previous ischemic stroke, diabetes, peripheral arterial disease, or chronic renal dysfunction. Canadian Journal of Cardiology 2013 29, 1334-1345DOI: (10.1016/j.cjca.2013.07.001) Copyright © 2013 Terms and Conditions

Figure 2 Recommendations for non-ST–elevation acute coronary syndrome (NSTEACS) 2. ASA, acetylsalicylic acid; PCI, percutaneous coronary intervention; TIA, transient ischemic attack. * Prasugrel should be avoided in patients with previous TIA or stroke. In patients aged 75 years and older, or body weight ≤ 60 kg, prasugrel should be used with caution and a 5-mg dose considered. Canadian Journal of Cardiology 2013 29, 1334-1345DOI: (10.1016/j.cjca.2013.07.001) Copyright © 2013 Terms and Conditions

Figure 3 Recommendations for ST-elevation myocardial infarction (STEMI). ASA, acetylsalicylic acid; PCI, percutaneous coronary intervention; TIA, transient ischemic attack. * Prasugrel should be avoided in patients with previous TIA or stroke. In patients aged 75 years and older, or body weight ≤ 60 kg, prasugrel should be used with caution and a 5-mg dose considered. Canadian Journal of Cardiology 2013 29, 1334-1345DOI: (10.1016/j.cjca.2013.07.001) Copyright © 2013 Terms and Conditions

Figure 4 Recommendations after CABG. ACS, acute coronary syndrome; ASA, acetylsalicylic acid; CABG, coronary artery bypass grafting; DAPT, dual antiplatelet therapy. Canadian Journal of Cardiology 2013 29, 1334-1345DOI: (10.1016/j.cjca.2013.07.001) Copyright © 2013 Terms and Conditions