It is reasonable to continue b-blockers beyond 3 years as chronic therapy in all patients with normal left ventricular function who have had myocardial infarction or ACS.139,142,143 (Level of Evidence: B) 2. It is reasonable to give b-blocker therapy in patients with left ventricular systolic dysfunction (ejection fraction #40%) without heart failure or prior myocardial infarction. (Level of Evidence: C) Class IIb 1. b-Blockers may be considered as chronic therapy for all other patients with coronary or other vascular disease. (Level of Evidence: C) Influenza vaccination Class I 1. Patients with cardiovascular disease should have an annual influenza vaccination.144 147 (Level of Evidence: B) Depression Class IIa 1. For patients with recent coronary artery bypass graft surgery or myocardial infarction, it is reasonable to screen for depression if patients have access to case management, in collaboration with their primary care physician and a mental health specialist.148 152 (Level of Evidence: B) Class IIb 1. Treatment of depression has not been shown to improve cardiovascular disease outcomes but may be reasonable for its other clinical benefits. (Level of Evidence: C) Cardiac rehabilitation Class I 1. All eligible patients with ACS or whose status is immediately post coronary artery bypass surgery or post-PCI should be referred to a comprehensive outpatient cardiovascular rehabilitation program either prior to hospital discharge or during the first follow-up office visit.55,154,161,163 (Level of Evidence: A) 2. All eligible outpatients with the diagnosis of ACS, coronary artery bypass surgery or PCI (Level of Evidence: A),55,154,155,161 chronic angina (Level of Evidence: B),161,163 and/or peripheral artery disease (Level of Evidence: A)158,164 within the past year should be referred to a comprehensive outpatient cardiovascular rehabilitation program. 3. A home-based cardiac rehabilitation program can be substituted for a supervised, center-based program for low-risk patients.153,159,160 (Level of Evidence: A) Class IIa 1. 