Acute coronary syndromes (ACS) are usually caused by rupture or erosion of atherosclerotic plaque with subsequent development
of intra-arterial thrombus. Therefore, dual antiplatelet therapy represents the mainstay of ACS treatment.
In patients with myocardial infarction with ST segment elevation (STEMI), reperfusion therapy should be performed as
soon as possible. Most effective reperfusion treatment is primary angioplasty. In ACS patients without ST segment elevation
(NSTE-ACS), according to appropriate risk stratification, an early invasive management is indicated. This review
article assesses the suitability of pretreatment with platelet receptors P2Y12 inhibitors (clopidogrel, prasugrel, ticagrelol
and cangrelor) in ACS patients. We present the guidelines concerning this therapy.