Antiplatelet therapy with low dose aspirin (75-100mg) is recommended indefinitely after myocardial infarction (MI).
In patients with true aspirin intolerance, clopidogrel 75 mg should be considered as an alternative.
More potent anti-platelet agents (such as prasugrel or ticagrelor) are recommended as dual anti-platelet therapy in combination with aspirin in patients with acute coronary syndromes.
Dual antiplatelet therapy is recommended for up to 12 months post MI with a minimum of
1 month for patients also receiving a bare metal stent
6 months for patients also receiving a drug eluting stent
Lipid lowering therapy
Intensive statin therapy is recommended in all patients following MI in the absence of a contraindication or intolerance, irrespective of initial cholesterol values.
Statins should be prescribed with a ‘lower is better’ approach to achieve levels of at least <2.5 mmol/L for non-HDL-c (equivalent to <1.8 mmol/L for LDL-cholesterol).