A full year of clopidogrel therapy is indicated in this patient who has sustained a non–ST-elevation myocardial infarction (NSTEMI). Clopidogrel added to aspirin improves outcomes after hospitalization in patients with NSTEMI regardless of the in-hospital treatment approach. Current recommendations from the American College of Cardiology and the American Heart Association state that all patients with an acute coronary syndrome (unstable angina, NSTEMI, or ST-elevation myocardial infarction) treated medically or with a stent (bare metal stent or drug-eluting stent) should be given P2Y₁₂ inhibitor therapy (for example, clopidogrel, prasugrel, or ticagrelor) in addition to aspirin for at least 12 months.

Patients who receive a stent in the absence of an acute coronary syndrome (that is, for stable angina pectoris) also require dual antiplatelet therapy with aspirin and clopidogrel until endothelialization of the stent is completed and the risk for acute stent thrombosis decreases. For a bare metal stent placed under these circumstances, clopidogrel should be continued for at least 1 month; for a drug-eluting stent, clopidogrel should be continued for at least 1 year. There is no indication for dual antiplatelet therapy for less than 1 month. Neither ticagrelor nor prasugrel has been studied extensively in patients undergoing coronary stent implantation for stable angina pectoris; therefore, these patients should be treated with clopidogrel in addition to aspirin.