17 Short Title: PM-2: Aspirin at Discharge PM-2: AMI: Aspirin Prescribed at Discharge Measure Description: Percentage of patients, age 18 y, hospitalized with AMI who are prescribed aspirin at hospital discharge. Numerator Patients with AMI who are prescribed aspirin at hospital discharge Denominator All patients with AMI Denominator Exclusions Patients age <18 y Patients who leave against medical advice Patients who die during hospitalization Patients who are on comfort care measures only or hospice Patients who are transferred to another hospital for inpatient acute care Denominator Exceptions Documentation of a medical reason for not prescribing aspirin at discharge (eg, aspirin allergy or intolerance, oral anticoagulant therapy at discharge, active bleeding) Patient currently enrolled in a clinical trial precluding the use of aspirin in its protocol (eg, trials of triple versus dual therapy in atrial fibrillation patients) Measurement Period Encounter Sources of Data Medical record or other database (eg, administrative, clinical, registry) Attribution Measure reportable at the facility or provider level Care Setting Inpatient Rationale Coronary heart disease with atherosclerotic plaque disruption (eg, rupture, erosion, ulceration) and superimposed platelet-rich thrombus formation are the main pathophysiological mechanisms causing MI (type 1 or spontaneous MI). Acute occlusion of the coronary artery by the plaque + superimposed thrombus complex results in acute imbalance in myocardial oxygen demand and supply which, when prolonged and unabated, leads to myocardial cell necrosis and infarction. 