Which of the following is the preferred antiplatelet therapy for a patient who has had a drug-eluting stent placed and is on aspirin?

The preferred antiplatelet therapy for a patient who has had a drug-eluting stent placed and is already on aspirin is ticagrelor 90 mg twice daily. This choice is supported by several key clinical considerations.

Ticagrelor is a potent P2Y12 inhibitor that offers faster onset of action and greater antiplatelet effect compared to clopidogrel. In addition, studies such as the PLATO trial have demonstrated that ticagrelor reduces the risk of major adverse cardiovascular events compared to clopidogrel in patients with acute coronary syndromes, particularly in those undergoing percutaneous coronary intervention (PCI) with stent placement. The dual antiplatelet therapy (DAPT) regimen of aspirin and ticagrelor is advised for a period typically ranging from 12 months to 24 months after stent implantation, especially with drug-eluting stents.

While prasugrel could be a viable alternative due to its efficacy, it is more suitable for specific populations (e.g., patients with a history of myocardial infarction) and has a higher risk of bleeding in patients with a history of stroke or transient ischemic attacks. Cangrelor is primarily used in the acute hospital setting and is not