NICE has published guidance (TA182) recommending prasugrel in combination with aspirin as an option for preventing atherothrombotic events in people with acute coronary syndromes (ACS) having percutaneous coronary intervention (PCI), only when:

• immediate primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction is necessary or
• stent thrombosis has occurred during clopidogrel treatment or
• the patient has diabetes mellitus.

NICE advises that people currently receiving prasugrel for treatment of ACC who do not meet the criteria above should have the option to continue therapy until they and their clinicians consider it appropriate to stop.