The Living Guidelines: STEMI Recommendations for ACE Inhibitors Therapy Suggest Revisions to the CLASS I Guidelines
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Class I Guidelines
- ACE inhibitors should be started and continued indefinitely in all patients recovering from ST segment elevation myocardial infarction (STEMI) with Left Ventricular Ejection Fraction (LVEF) less than or equal to 40% and for those with hypertension, diabetes, or chronic kidney disease, unless contraindicated. Class I (Level of Evidence: A) 
- ACE inhibitors should be started and continued indefinitely in patients recovering from STEMI who are not lower risk (lower risk defined as those with normal Left Ventricular Ejection Fraction (LVEF) in whom cardiovascular risk factors are well controlled and revascularization has been performed), unless contraindicated. Class I (Level of Evidence: B) 
- ↑ 1.0 1.1 Antman EM, Hand M, Armstrong PW, Bates ER, Green LA, Halasyamani LK, Hochman JS, Krumholz HM, Lamas GA, Mullany CJ, Pearle DL, Sloan MA, Smith SC Jr; 2004 Writing Committee Members, Anbe DT, Kushner FG, Ornato JP, Jacobs AK, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation 2008 Jan 15;117(2):296-329 PMID 18071078
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