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		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Following cardiac catheterization and stent placement, patients are usually prescribed dual antiplatelet therapy (DAPT). With drug-eluting stents (DES), patients are usually prescribed clopidogrel ideally for 12 months along with life-long aspirin therapy. In contrast, patients who receive bare metal stents receive a shorter duration of dual antiplatelet therapy, where clopidogrel administration is limited to only one month (while aspirin is still continued for life). While drug-eluting stents are associated with a reduced risk of stent thrombosis, the limited duration of dual antiplatelet therapy with bare metal stents may be beneficial among patients who are at very high risk of bleeding, such as those alreay receiving other forms of anticoagulation for other diseases (e.g. patients with atrial fibrillation who are already receiving warfarin therapy). Accordingly, limited antiplatelet therapy with clopidogrel is associated with a reduced risk of bleeding among these patients. To date, aspirin is indicated in all patients for the secondary prevention of acute coronary syndromes (ACS), which includes STEMI, NSTEMI, and unstable angina. Aspirin is an irreversible inhibitor of cyclooxygenase (COX1 and COX2) that acts by the process of covalent acetylation. It reduces thromboxane A2 synthesis and prolongs bleeding time, without affecting the prothrombin time (PT) or partial thromboplastin time (PTT). Platelet dysfunction with aspirin therapy is described as functional, i.e. there is no actual decrease in the numbers of platelet count, but patients have a reduced platelet function and are thus at high risk of bleeding. Recently and with the introduction of novel oral factor Xa anticoagulants (NOACs), a novel "dual pathway" approach (thrombin inhibition by factor Xa inhibitors along with platelet inhibition) is currently being evaluated for the secondary prevention of ACS and may replace the traditional "dual antiplatelet" approach (aspirin plus thienopyridine).&lt;br/&gt;
'''Educational Objective:''' Patients receiving aspirin typically have a prolonged bleeding time with normal PT, PTT, and platelet counts. Aspirin is associated with platelet dysfunction without affecting the actual platelet count.&lt;br/&gt;
'''References:''' First Aid 2014 page 439</property:Explanation>
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