From the Guidelines

After PCI, patients should take aspirin indefinitely and prasugrel for at least 12 months. Recommended regimen:

Aspirin: 81 mg daily, indefinitely
Prasugrel: 10 mg daily for at least 12 months It's crucial to take both medications as prescribed without interruption, as stopping early increases the risk of stent thrombosis and heart attacks, which can significantly impact morbidity, mortality, and quality of life 1. Some patients may need to continue prasugrel beyond 12 months, depending on their individual risk factors and the type of stent used, as suggested by the 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease 1. These medications work together to prevent blood clots:
Aspirin inhibits platelet activation
Prasugrel blocks a specific receptor on platelets, further reducing clotting risk Always consult with your cardiologist before making any changes to this medication regimen, as they may adjust the duration or dosage based on your specific situation, bleeding risk, and overall health status, taking into consideration the latest guidelines and evidence, such as those from the 2016 ACC/AHA guideline 1. Key considerations include:
The risk of bleeding versus the benefit of continued therapy
The type of stent used and the individual patient's risk factors
The importance of adherence to the prescribed medication regimen to minimize the risk of adverse outcomes, as emphasized in the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention 1.

From the Research

The recommended duration of aspirin and prasugrel therapy after percutaneous coronary intervention (PCI) is as follows:

Aspirin should be continued indefinitely, with a low dose (75-100 mg daily) preferred over higher doses 2
Prasugrel, a P2Y12 inhibitor, should be administered for 12 months after PCI, unless the patient is at high risk for bleeding 2
However, the duration of dual antiplatelet therapy (DAPT) with aspirin and prasugrel may need to be tailored to individual patient ischemic and bleeding risks 3

For patients with acute coronary syndrome undergoing PCI:

Aspirin and prasugrel containing DAPT for 12 months may be considered, as it has a significantly lower incidence of major adverse cardiovascular events at 1 year 4
However, prasugrel containing DAPT for 12 months also has a significantly higher rate of major bleeding 4

For patients with atrial fibrillation undergoing PCI:

Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor should be given during the peri-PCI period, after which the default strategy is to stop aspirin and continue treatment with a P2Y12 inhibitor, preferably clopidogrel, in combination with a non-vitamin K antagonist oral anticoagulant 5
The duration of double therapy should be 6 to 12 months, depending on the ischemic and bleeding risk profile of the patient 5

The duration of aspirin and prasugrel therapy after PCI should be individualized based on patient risk factors and clinical presentation 2, 3, 5, 4
Prasugrel containing DAPT for 12 months may be considered for patients with acute coronary syndrome, but it also increases the risk of major bleeding 4
For patients with atrial fibrillation, double therapy with a P2Y12 inhibitor and a non-vitamin K antagonist oral anticoagulant should be given for 6 to 12 months after PCI 5