Table. Drugs used in secondary prevention of acute coronary syndrome.

Drug	Recommendations
Aspirin	Continue indefinitely unless contraindicated.
P2Y12 inhibitors	Continue for at least 12 months post-acute coronary syndrome, irrespective of whether coronary revascularisation has occurred, due to reduction in risk of recurrent acute coronary syndrome, stroke or death. Continuation beyond 12 months should be decided in conjunction with the treating cardiologist.
Statins	The highest tolerated dose of statins should be continued indefinitely to achieve low-density lipoprotein targets ≤1.8 mmol/L. Consider addition of ezetimibe. Consider PCSK9 inhibitor therapy if low-density lipoprotein remains >2.6 mmol/L despite maximally tolerated doses of statin and ezetimibe.
Renin–angiotensin antagonists	Post-acute coronary syndrome, ACE inhibitor or angiotensin receptor antagonist limit infarct size and left ventricular remodelling, and reduce overall cardiovascular mortality, non-fatal myocardial infarction and stroke.3 These drugs should be increased to the highest tolerated doses for maximum benefit, especially if there is concurrent hypertension or left ventricular dysfunction.19 Blood pressure targets of 130–140 mmHg systolic and 80–90 mmHg diastolic should be considered.
Beta blockers	The benefit of beta blockers is equivocal in patients with preserved left ventricular function, especially beyond one year after infarction, in the modern era of primary percutaneous coronary intervention. They can be used, however, if further antihypertensive drugs are required.