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Table 1 Summary of guideline recommendations for medications post-STEMI

From: Delayed educational reminders for long-term medication adherence in ST-elevation myocardial infarction (DERLA-STEMI): Protocol for a pragmatic, cluster-randomized controlled trial

Medication Recommendation Strength of evidence*
Anti-platelets Aspirin therapy (75-162 mg/day) indefinitely post-STEMI. I A
  P2Y12-receptor inhibitor (clopidogrel, prasugrel, or ticagrelor) in combination with aspirin in patients post ACS I A
  P2Y12-receptor inhibitor continued for at least 12 months if ACS managed with PCI and stent placement I A
Statins Statin therapy indefinitely for all patients with a prior cardiovascular event. I A
Angiotensin-system agent ACE inhibitor (or ARB if intolerant) post-STEMI indefinitely for all patients with left ventricular ejection fraction <40% and in those with hypertension, diabetes, or chronic kidney disease I A
  ACE inhibitor (or ARB) for all patients post-STEMI IIa B
Beta-blockers Beta-blockers for all patients post-STEMI I A
  Beta-blockers continued for at least three years post-STEMI I B
  1. *Strength of Evidence.
  2. I: Conditions for which there is evidence and/or general agreement that a given treatment is beneficial, useful, and effective.
  3. IIa: Weight of evidence/opinion is in favor of usefulness/efficacy.
  4. A: Data derived from multiple randomized clinical trials or meta-analyses.
  5. B: Data derived from a single randomized trial, or nonrandomized studies.