Platelet P2Y12 receptor blocker loading doses in acute STEMI

Reperfusion	Type	Age (years)	Preferred drug (loading dose)
Yes	PCI	ALL	Ticagrelor loading dose 180 mg or prasugrel loading dose 60 mg, in patients without contraindications*. Both are preferred to clopidogrel.
	PCI	ALL	Clopidogrel loading dose 300-600 mg (600 mg is preferred), in patients for whom ticagrelor or prasugrel is not chosen
	Fibrinolysis	≤75	Clopidogrel 300 mg
	Fibrinolysis	>75	Clopidogrel 75 mg
No	--	ALL	Ticagrelor 180 mg

STEMI: ST-elevation myocardial infarction; PCI: percutaneous coronary intervention.
* Absolute contraindications to prasugrel include a history of stroke or transient ischemic attack (TIA) or active pathological bleeding. Weight <60 kg and age ≥75 years are relative contraindications.

Graphic 73079 Version 15.0

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Platelet P2Y12 receptor blocker loading doses in acute STEMI