Although STEMI is usually readily diagnosed by the presence of acute current of injury on the presenting ECG, patients with NSTE-ACS can present with nonspecific changes on the ECG (eg, subtle or nonspecific ST or T wave changes). Thus, measuring troponin levels expeditiously help in the early diagnosis and risk stratification of these patients, which can lead to earlier triage and institution of appropriate medical and interventional treatments.11 Clinical Recommendation(s) 2014 AHA/ACC Guideline for the Management of Patients With Non ST-Elevation Acute Coronary Syndromes11 1. Serial cardiac troponin I or T levels (when a contemporary assay is used) should be obtained at presentation and 3 to 6 hours after symptom onset in all patients who present with symptoms consistent with ACS to identify a rising and/or falling pattern of values.8,142 147 (Class I, Level of Evidence: A) 2. Additional troponin levels should be obtained beyond 6 hours after symptom onset in patients with normal troponin levels on serial examination when changes on ECG and/or clinical presentation confer an intermediate or high index of suspicion for ACS.8,148 150 (Class I, Level of Evidence: A) 3. If the time of symptom onset is ambiguous, the time of presentation should be considered the time of onset for assessing troponin values.143,145,150 (Class I, Level of Evidence: A) ACC indicates American College of Cardiology; ACS; acute coronary syndrome; AHA, American Heart Association; AMI, acute myocardial infarction; ED, emergency department; NSTE-ACS, non ST-elevation acute coronary syndrome; NSTEMI, non ST-elevation myocardial infarction; and STEMI, ST-elevation myocardial infarction. Appendix A. Continued 33 Short Title: PM-17: AMI Registry Participation PM-17: AMI: Participation in 1 Regional or National Registries That Include Patients With Acute Myocardial Infarction Measure Description: Participation in a national or regional AMI registry that provides regular performance reports based on benchmarked data. 