P2RY12 and acute coronary syndrome: Although there is a biological rationale for early use of these drugs, recent updates in the European Society of Cardiology guidelines for acute coronary syndromes have downgraded the recommendation of routine pre-treatment with P2Y12, reflecting the lack of significant evidence supporting routine use in all cases of STEMI.7 This consideration was particularly pertinent in this case, where stenting was forgone after identifying that myocardial injury was caused by septic emboli rather than atherosclerotic coronary plaque rupture.