ACTION Registry-GWTG Results: January 1, 2009 – December 31, 2009

Current Site Distribution Last updated: 4/13/2010 AK (1) WA (8) OR (10) CA (36) ID (2) NV (7) MT (2) WY (0) CO (13) NM (2) ND (1) SD (1) NE (6) KS (9) OK (7) TX (64) MN (6) IA (6) MO (18) AR (1) LA (7) WI (7) MI (11) MI UT (2) AZ (5) HI (4) IL (33) IN (17) KY (4) TN (19) MS (6) AL (9) GA (14) FL (36) SC (12) NC (25) VA (13) OH (30) WV (1) PA (27) NY (18) MD (12) ME (1) VT (0) NH (1) NJ (6) MA (6) CT (6) DE (0) RI (1) DC (0) Active Sites = 539 PR(2)

Baseline Characteristics - STEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Hospital Presentation Characteristics - STEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

In-Hospital Outcomes - STEMI *Unadjusted mortality ** Among non-CABG pts *Unadjusted mortality ** Among non-CABG pts ACTION Registry-GWTG DATA: January – December 31, 2009

Use of Reperfusion Therapy for STEMI STEMI N = 23,190 Reperfusion N = 18,871 (81%) No Reperfusion – No Contraindication Listed N = 1333 (6%) Not Eligible for Reperfusion Therapy Contraindication Listed N= 2,898 (13%) Primary PCI – 88%* Fibrinolytics – 11%* Both PCI + Lytics – 1%* 94% of eligible patients reperfused * Among patients receiving reperfusion ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

DTB = 1 st Door to Balloon for Primary PCI DTN = Door to Needle for Lytics STEMI – Door to Balloon and Door to Needle Times: Cumulative 12 Month Data ACTION Registry-GWTG DATA: January 1,2009 – December 31, 2009

STEMI Primary PCI Results - Non-Transfer Patients with DTB  90 mins 73% of the primary PCI patients are not transferred in

STEMI Primary PCI Results - DTB Benchmarks for Transfer-In Patients 1 st Door to Balloon < 90 Minutes 1 st Door to Balloon < 120 Minutes 27% of the primary PCI patients are transferred in

STEMI Door-to-Balloon Times – Median Times for Transfer In and Non-Transfer In Patients Transfer in DTB TimesNon-Transfer in DTB Times Q Q Q Q4 09 Time (min)

STEMI Acute (< 24 hrs) Medications ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009 n * Heparin and GP IIb-IIIa administered any time during hospitalization

STEMI Revascularization Strategy Trends ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009 PCI Medically Managed CABG

STEMI Discharge Medications % Use ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

STEMI Discharge Interventions ACTION Registry-GWTG DATA: January 1,2009 – December 31, 2009

Baseline Characteristics - NSTEMI

Hospital Presentation Characteristics - NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

In-Hospital Outcomes - NSTEMI *Unadjusted mortality ** Among non-CABG pts *Unadjusted mortality ** Among non-CABG pts ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

NSTEMI Acute (< 24 hrs) Medications ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009 * Heparin and GP IIb-IIIa administered any time during hospitalization

NSTEMI Time from Presentation to Procedure ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

NSTEMI Acute Medication Overdosing Trends * Infusion (> 15 units/kg/hr) or bolus (> 70 units/kg) # Initial dose (> 1.05 mg/kg) or total 24 hr dose (> 10 mg over recommended) ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

NSTEMI Invasive Cardiac Procedures ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

NSTEMI Revascularization Strategy Trends ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009 PCI Medically Managed CABG

NSTEMI Discharge Medications ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

NSTEMI Discharge Clopidogrel Use by Revascularization Strategies ACTION Registry-GWTG DATA: January 1, 2009– December 31, 2009

NSTEMI Discharge Interventions ACTION Registry-GWTG DATA: January 1, 2009– December 31, 2009

Baseline Characteristics – STEMI vs. NSTEMI

Age Distribution – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Location of First Evaluation – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Hospital Presentation Characteristics - STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

In-Hospital Outcomes - STEMI vs. NSTEMI *Unadjusted mortality ** Among non-CABG pts *Unadjusted mortality ** Among non-CABG pts ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Non-CABG Major Bleeding and Transfusion – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Acute Medications - STEMI vs NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Discharge Medications - STEMI vs NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009

Discharge Interventions – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1, 2009 – December 31, 2009