In the PLATO (Platelet Inhibition and Patient Outcomes) trial, the rate of the combined cardiovascular endpoint (vascular death, MI, or stroke) was 11.7% at 12 months among AMI patients treated with aspirin and clopidogrel.7 This included a 6.9% rate of recurrent MI at 12 months.7 In 2010 alone, about 595000 inpatient hospital discharges were attributed to AMI.3 AMI is also associated with a substantial direct and indirect cost burden, and is classified among the top 10 most expensive hospital principal discharge diagnoses.3 As indicated in the Third Universal Definition of Myocardial Infarction consensus document published in AMI is defined by the detection of a rise and/or fall of cardiac biomarkers (preferably cardiac troponin levels) with at least 1 value above the 99th percentile upper reference limit and with at least one of the following: (a) symptoms of ischemia; (b) new or presumed new signi cant ST-segment T wave changes or new left bundle branch block; (c) develop- ment of pathological Q waves in the electrocardiogram (ECG); (d) imaging evidence of new loss of viable myocardium or new regional wall motion abnormality; (e) identi cation of an intracoronary thrombus by angiography or autopsy. The Third Universal Definition of Myocardial Infarction consen- sus document, published in 2012, classifies MI into 5 types, based on pathological, clinical, and prognostic differences, along with different treatment strategies.8 The performance and quality measures described in the current document are predominantly pertinent to patients with spontaneous MI, or MI type 1. MI type 1 is an event related to atherosclerotic plaque disruption (eg, rupture, ulceration, erosion) with super- imposed thrombus formation in a coronary artery, resulting in acute reduction in myocardial blood supply and/or distal embolization with subsequent myonecrosis. 