Women further were characterized by a higher risk for bleeding with antithrombotic therapy, which persisted after consideration of age, weight, blood pressure (BP) at presentation, renal function, baseline hematocrit, and other Nonwhites represented 13.3% of patients with STEMI at hospitals participating in the ACTION Registry GWTG Importantly, disparities in the treatment of racial and ethnic minorities appear to be improv- ing over time.23 In an assessment of the effects of a statewide program for treatment of STEMI, institution of a coordinated regional approach to triage and management was associated with significant improvements in treatment times that were similar for whites and blacks and for women and men.23 The writing committee endorses the desirability of collecting and using accurate data on patient race and ethnicity to detect dis- parities, guide quality improvement initiatives, and strengthen ties to the community.24 Approximately 23% of patients with STEMI in the United States have diabetes mellitus,17 and three quarters of all deaths among patients with diabetes mellitus are related to coronary artery disease.25,26 Diabetes mellitus is associated with higher short- and long-term mortality after STEMI,27,28 and in patients with diabetes mellitus, both hyperglycemia and hypoglycemia are associated with worse outcomes.29 Hyperglycemia at presentation in patients who do not have diabetes mellitus by history has been associated with worse Myocardial tissue perfusion after restoration of epicardial coronary flow was more impaired among patients with diabetes mellitus ( no-reflow ).28,35,36 Management of patients with diabetes mellitus and STEMI should be the same as for patients without diabetes mellitus, with attention to moderate glycemic control. The elderly comprise a growing segment of the population and present special challenges for diagnosis and management that may lead to disparities in care and delays in treatment. 