In the setting of an acute coronary syndrome (ACS), dual antiplatelet therapy (DAPT) consisting of aspirin with a P2Y12 inhibitor for at least 12 months has been found to reduce the incidence of recurrent myocardial infarction (MI) and death.98–100 Both prasugrel and ticagrelor have demonstrated superiority compared with clopidogrel.99,100 In ACS treated with percutaneous coronary intervention (PCI), ticagrelor is also superior to clopidogrel.99 Prasugrel should be avoided in patients with history of transient ischemic attack (TIA) or stroke. This evidence concerns the gene P2RY12 and acute coronary syndrome.