Numerator Patients with acute STEMI (or its equivalent*) defined by characteristic symptoms of myocardial ischemia with diagnostic ST elevation on ECG, who are resuscitated from out-of-hospital cardiac arrest and receive immediate angiography *Patients with STEMI equivalent on ECG may have: hyperacute T-wave changes, true posterior MI, multilead ST depression with coexistent ST elevation in lead aVR, characteristic diagnostic criteria in the setting of LBBB Note: Immediate angiography is defined as invasive angiography within 120 min after resuscitation from out-of-hospital cardiac arrest. Denominator All patients with STEMI who are resuscitated from out-of-hospital cardiac arrest Denominator Exclusions Patients age <18 y Patients who die during hospitalization shortly following their out-of-hospital cardiac arrest (<120 min) Patients who are transferred to hospice or are placed on comfort care measures shortly after their out-of-hospital cardiac arrest (<120 min) Patients received in transfer from another facility Denominator Exceptions Documentation of a medical reason for not receiving immediate angiography after resuscitated out-of-hospital cardiac arrest (eg, contraindications to invasive angiography, terminal illness/futile medical condition) Documentation of a patient reason for not receiving immediate angiography after resuscitated out-of-hospital cardiac arrest (eg, patient s will or family wishes) Documentation of a system reason for not receiving immediate angiography after resuscitated out-of-hospital cardiac arrest (eg, presentation to a non PCI capable hospital and too unstable to transfer) Measurement Period Encounter Sources of Data Medical record or other database (eg, administrative, clinical, registry) Attribution Measure reportable at the facility or provider level Care Setting Inpatient Rationale Many patients with cardiac arrest and ST elevation on the ECG often have high-risk coronary anatomy, which may benefit from timely coronary angiography to identify severe coronary artery disease and possibly guide/dictate revascularization (usually with PCI).12,122 137 Clinical Recommendation(s) 2013 ACCF/AHA Guideline for the Management of Patients With ST-Elevation Myocardial Infarction12 1. 