In all patients with a recent or remote history of MI or ACS and reduced EF, evidence-based beta blockers should be used to reduce mortality (137 139). (Level of Evidence: B) Table 8. Recommendations for Invasive Evaluation Recommendations COR LOE Monitoring with a pulmonary artery catheter should be performed in patients with respiratory distress or impaired systemic perfusion when clinical assessment is inadequate I C Invasive hemodynamic monitoring can be useful for carefully selected patients with acute HF with persistent symptoms and/or when hemodynamics are uncertain IIa C When ischemia may be contributing to HF, coronary arteriography is reasonable IIa C Endomyocardial biopsy can be useful in patients with HF when a specific diagnosis is suspected that would influence therapy IIa C Routine use of invasive hemodynamic monitoring is not recommended in normotensive patients with acute HF III: No Benefit B (127) Endomyocardial biopsy should not be performed in the routine evaluation of HF III: Harm C COR indicates Class of Recommendation; HF, heart failure; and LOE, Level of Evidence. JACC Vol. 62, No. 16, 2013 Yancy et al. October 15, 2013:1495 539 2013 ACCF/AHA Heart Failure Guidelines: Executive Summary 3. In all patients with a recent or remote history of MI or ACS, statins should be used to prevent symptomatic HF and cardiovascular events (140 146). (Level of Evidence: A) 4. In patients with structural cardiac abnormalities, including LV hypertrophy, in the absence of a history of MI or ACS, blood pressure should be controlled in accordance with clinical practice guidelines for hypertension to prevent symptomatic HF (28,128 131). (Level of Evidence: A) 5. ACE inhibitors should be used in all patients with a reduced EF to prevent symptomatic HF, even if they do not have a history of MI (135,147). (Level of Evidence: A) 6. 