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The two novel antiplatelet agents prasugrel and ticagrelor provide better platelet inhibition than clopidogrel. These drugs were shown to be more effective than clopidogrel in most subsets of patients with ACS, but were associated with more bleeding complications. Careful patient selection and balancing the benefits and risks optimises the selection of prasugrel, ticagrelor and clopidogrel in ACS. Vorapaxar may be a good option for secondary prevention in patients with stable atherosclerosis and no history of stroke, TIA, or ICH.

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