Do you always give 325 mg aspirin if not already loaded with antiplatelets prior to the start of every LHC, even just for diagnostics in the absence of ACS?

Yes. I favor loading almost all patients prior to a LHC even if only diagnostic. That includes those on a DOAC as well. The reason I favor this is in case there was a complication and need for PCI that the patient at least has one anti-platelet in their system.

Most of my patients are undergoing outpatient pre-planned procedures. The majority are already on 81 mg of aspirin and a second antiplatelet. Therefore, giving an additional 325 mg Asprin would probably not be necessary.