Yeh and colleagues examined age- and sex-adjusted incidence rates for STEMI and NSTEMI from a community-based population (Northern California) between 1999 and 2008, and demonstrated an overall significant decrease in AMI incidence rate after 2000.6 Although the adjusted 30-day mortality rate after AMI decreased signifi- cantly (driven by a significant reduction in NSTEMI mortal- ity), the overall mortality rate in 2008 after an AMI was still Importantly, AMI patients who survive the initial event have substantial risk for future cardiovascular events, includ- ing recurrent MI, death, heart failure, and stroke. 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. 