Summary

Both the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery myocardial revascularization guidelines [Wijns W et al. Eur Heart J 2010] and American College of Cardiology Foundation, American Heart Association, and Society for Cardiovascular Angiography and Interventions percutaneous coronary intervention (PCI) guidelines [Levine GN et al. J Am Coll Cardiol 2011] recommend (with a Class I recommendation) the use of a loading dose of a P2Y12 receptor inhibitor before PCI with stenting. This article discusses alternatives to the Class I recommendation.