References selected and published in this document are representative and not all-inclusive. To provide clinicians with a comprehensive set of data, whenever deemed appropriate or when published, the abso- lute risk difference and number needed to treat or harm are provided in the guideline, along with confidence intervals (CI) and data related to the relative treatment effects such as odds ratio (OR), relative risk (RR), hazard ratio (HR), or incidence rate ratio. The focus of this guideline is the management of patients with ST-elevation myocardial infarction (STEMI). Updates to the 2004 STEMI guideline were published in 2007 and Particular emphasis is placed on advances in reper fusion therapy, organization of regional systems of care, transfer algorithms, evidence-based antithrombotic and medi- cal therapies, and secondary prevention strategies to opti mize patient-centered care. By design, the document is narrower in scope than the 2004 STEMI Guideline, in an attempt to pro- vide a more focused tool for practitioners. References related to management guidelines are provided whenever appropriate, including those pertaining to percutaneous coronary interven- tion (PCI), coronary artery bypass graft (CABG), heart failure (HF), cardiac devices, and secondary prevention. 1.2. Organization of the Writing Committee The writing committee was composed of experts representing cardiovascular medicine, interventional cardiology, electro- physiology, HF, cardiac surgery, emergency medicine, inter- nal medicine, cardiac rehabilitation, nursing, and pharmacy. The American College of Physicians, American College of Emergency Physicians, and Society for Cardiovascular Angi- ography and Interventions assigned official representatives. 1.3. 