After PCI, it is reasonable to use 81 mg of aspirin per day in preference to higher maintenance doses.84,85,118 122 (Level of Evidence: B) 3. For patients undergoing coronary artery bypass grafting, clopidogrel (75 mg daily) is a reasonable alternative in patients who are intolerant of or allergic to aspirin. (Level of Evidence: C) Class IIb 1. The benefits of aspirin in patients with asymptomatic peripheral artery disease of the lower extremities are not well established.108,109 (Level of Evidence: B) 2. Combination therapy with both aspirin 75 to 162 mg daily and clopidogrel 75 mg daily may be considered in patients with stable coronary artery disease.112 (Level of Evidence: B) Renin-angiotensin-aldosterone system blockers ACE inhibitors Class I 1. ACE inhibitors should be started and continued indefinitely in all patients with left ventricular ejection fraction 40% and in those with hypertension, diabetes, or chronic kidney disease, unless contraindicated.124,125 (Level of Evidence: A) Class IIa 1. It is reasonable to use ACE inhibitors in all other patients.126 (Level of Evidence: B) ARBs Class I 1. The use of ARBs is recommended in patients who have heart failure or who have had a myocardial infarction with left ventricular ejection fraction 40% and who are ACE-inhibitor intolerant.130 132 (Level of Evidence: A) Class IIa 1. It is reasonable to use ARBs in other patients who are ACE-inhibitor intolerant.133 (Level of Evidence: B) Class IIb 1. The use of ARBs in combination with an ACE inhibitor is not well established in those with systolic heart failure.132,134 (Level of Evidence: A) Aldosterone blockade Class I 1. 