An independent evidence review committee is commissioned when there are one or more questions deemed of utmost clinical importance that merit for- mal systematic review to determine which patients are most likely to benefit from a drug, device, or treatment strategy, and to what degree. Criteria for commissioning an evidence review committee and formal systematic review include absence of a current authoritative systematic review, feasibility of defining the benefit and risk in a time frame consistent with the writing of a guideline, relevance to a substantial number of patients, and likelihood that the findings can be translated into actionable recommendations. Evidence review committee members may include methodologists, epidemiologists, clinicians, and bio- statisticians. Recommendations developed by the writing committee on the basis of the systematic re- view are marked SR . Guideline-Directed Management and Therapy The term guideline-directed management and therapy (GDMT) encompasses clinical evaluation, diagnos- tic testing, and both pharmacological and procedural treatments. For these and all recommended drug treat- ment regimens, the reader should confirm dosage with product insert material and evaluate for contraindica- tions and interactions. Recommendations are limited to drugs, devices, and treatments approved for clinical use in the United States. Patrick T. O Gara, MD, MACC, FAHA Chair, ACC/AHA Joint Committee on Clinical Practice Guidelines 1.1. Methodology and Evidence Review The recommendations listed in this document are, whenever possible, evidence based. An extensive review was conducted on literature published through March 1, 2020. Searches were extended to studies, reviews, and other evidence involving human subjects that were published in English and indexed in PubMed, EMBASE, Cochrane, Agency for Healthcare Research and Quality Reports, and other selected databases relevant to this guideline. 