Furthermore, continuous research to examine temporal trends and disparities (ie, with respect to sex, age, ethnicity) in the achievement of performance and quality measures will help guide future revisions as well as the implementation of the current set. While the majority of current measures are binary (for example, yes or no for medication prescription), the next frontier in performance evaluation may be also to measure doses of prescribed pharmacotherapies and compare them to doses used in ran- domized trials showing benefit. Finally, the ACC ACTION Registry Get With The Guidelines implemented a Defect- Free Care measure for AMI patients, which was endorsed by the National Quality Forum. Our writing committee did not adopt this measure in the current document to avoid the additional burden of data abstraction and reporting. This is QM-4 Inpatient Aldosterone Antagonist at Discharge This measure seeks to implement Class I recommendations in the 2013 ACCF/AHA STEMI12 guidelines supporting the use of aldosterone antagonists in eligible patients with STEMI and NSTEMI, respectively. The writing committee felt it is best to keep this as a quality measure because of issues related to the measure construct. This measure is likely to present a significant abstraction burden and may be relevant only to a small fraction of AMI patients (given the elaborate inclusion/ exclusion criteria in the EPHESUS29 clinical trial). QM-5 Inpatient Inappropriate In- Hospital Use of NSAIDs This measure seeks to implement Class III recommendations (Class III Harm, Level of Evidence: B) in both the 2013 ACCF/AHA guidelines, cautioning against the use of these drugs after AMI. The writing committee felt it is best to keep this as a quality measure given the low impact associated with the use of NSAIDs during the brief hospitalization period (this is likely more relevant in the outpatient setting). 