Criteria:  Please see https://drive.google.com/drive/folders/1WD618wrywYjEaXzfLTcuK-VCcnb6b-gV for full code and algorithm definitions.  Inclusion Criteria:  Hospitalization for unstable angina or acute MI AND age >= 18 years Days [ACS admission]  STEMI OR NSTEMI/unstable angina (during admission) + 1 of the following  >= 60 years old Days [ACS] >= 3 risk factors for coronary artery disease Diabetes mellitus Chronic renal disease Carotid stenosis >= 50% or cerebral revascularization Peripheral artery disease Days [-365, ACS] Aspirin use Angina Days [-7, ACS] Prior MI or CABG any time prior  Exclusion Criteria:  Acute complication PCI Days [-30, ACS admission] History of any stroke or TIA Days [all available data, 0] Intracranial neoplasm, intracranial AVM, intracranial neoplasm Days [-180, 0] Active bleeding Days [-180, 0] Platelet count < 100.000/uL Days [-180, 0] Anemia (hemoglobin < 10 g/dL) Days [-180, 0] Chronic renal insufficiency requiring dialysis Days [-180, 0] Moderate to severe hepatic dysfunction Days [-180, 0] Increased risk of bradycardia events Days [-180, 0] Life expectancy, 1 year Days [-180, 0] Pregnancy Days [-180, 0] Concomitant therapy CYP3A inhibitors, CYP3A substrates, or strong CYP3A inducers Days [-14, 0]