1. 20090417 A Prospective Randomized Trial of CMX- 2043, a Lipoic Acid-Based Cytoprotectant, In Patients Undergoing Elective PCI: Primary Results of the SUPPORT-1 Trial Mitchell W. Krucoff, C.K. Ponde, Jagdish Hiremath, Mullasari Ajit, Eddison Ramsaran, Manesh R. Patel, Alan S. Lader, F. Howard Schneider, Reinier Beeuwkes, C. Michael Gibson, and James E. Tcheng.

2. 20090417 Conflict of Interest   Clinical Advisory Board, Ischemix

3. 20090417 Incidence & Implications of Peri-Procedural MI: A Controversy of Definitions & Pathophysiology  Resolute All Comers  2,121 patients Incidence: 3.6-17.8% 3 yr mortality: 2-8%

4. 20090417 PCI: A Human Laboratory for Cytoprotection  PCI produces enzymatic events  Selected protein elevations (CPK-MB, Troponin) represent myocellular necrosis  PCI as a laboratory for RCT of cytoprotective strategies has FDA predicate (vitamin B6 metabolite  PCI as a laboratory for RCT of cytoprotective strategies has FDA predicate (vitamin B6 metabolite pyridoxal-5’- phosphate monohydrate (MC- 1) in the MC-1 to Eliminate Necrosis and Damage (MEND-1)

5. 20090417 CMS-2043: A Novel Molecular Entity to Inhibit Ischemic Apoptosis Reactive oxygen species (ROS) anti-oxidant, AND Activates Akt (Ak mouse thymoma = Protein kinase B) via tyrosine kinase (TK)

6. 20090417 The SUPPORT 1 Study Safety and Efficacy of CMX-2043 in Subjects Undergoing PCI and Peri- Operative Reperfusion Treatment

7. 20090417 SUPPORT-1: Study Design   Phase IIa Safety & Efficacy: CMX-2043   Prospective, randomized 3:1 3 doses (0.8, 1.6 & 2.4 mg/kg) vs placebo   Multi-center (N=6)   Elective PCI Patients WNL biomarkers & Non-acute ECG Receiving single stent of ≥ 18 mm or multiple stents   Primary Outcome Measures: Incidence of CK-MB elevation <24 hours following PCI Change in cardiac biomarkers <24 hrs following PCI   CK-MB, Troponin T   Secondary Outcome Measure: MI as >X3 peak CPK

8. 20090417 SUPPORT-1 Exclusion Criteria   Acute/unstable angina   MI within 14 days   Coagulopathy   Clinical valvular disease   Clinical peripheral vascular disease   TIA, stroke or IC bleed within 90 days   Creatinine level ≥ 1.5 times ULN

9. 20090417 SUPPORT-1 Sites and Investigators

10. 20090417 SUPPORT I: Patient Accrual/Randomization

11. 20090417 SUPPORT-1 Baseline Characteristics

12. 20090417 SUPPORT I: Arteries Stented Per Rx Group

13. 20090417 Primary Endpoint: 24 Hr CK-MB Change from Baseline

14. 20090417 24 Hr CK-MB Change From Baseline (ng/mL) CMX-2043 treatment p=0.05 vs. Placebo p = 0.05

15. 20090417 24 Hr Troponin T Change from Baseline CMX-2043 treatment

16. 20090417 24 Hr Peri-Procedural MI by CK-MB >X3 ULN CMX-2043 treatment p=0.024 vs. Placebo

17. 20090417 24 Hr Peri-Procedural MI by Troponin T >X3 ULN CMX-2043 treatment p=0.050 vs. Placebo

18. 20090417 SUPPORT-1 Adverse Events Summary Category 0.8 mg/kg (N = 36) 1.6 mg/kg (N = 35) 2.4 mg/kg (N = 36) Placebo (N = 34) Any AEs7 ( 19.44%)14 ( 40.00%)11 ( 30.56%)10 ( 29.41%) Drug Related AEs0 ( 0.00%)3 ( 8.57%)1 ( 2.78%)2 ( 5.88%) Serious AEs1 ( 2.78%)2 ( 5.71%)1 ( 2.78%)0 ( 0.00%) AEs leading to Study discontinuation 0 ( 0.00%)1 ( 2.86%)0 ( 0.00%) Deaths0 ( 0.00%)

19. 20090417 SUPPORT I: Limitations  Serum marker elevations with elective PCI have biochemical relevance for NME testing vs. human apoptosis, however the clinical relevance of these findings is unproven

20. 20090417 SUPPORT I Primary Results: Conclusions  SUPPORT I was a prospective, randomized, multicenter Phase IIa dosing study of protection from PCI-induced myonecrosis by CMX-2043 infusion  All doses of CMX-2043 studied (0.8, 1.6 and 2.4 mg/kg) appeared safe in this population  High dose (2.4 mg/kg) infusion of CMX-2043 was associated with statistically significant reduction of serum markers of myonecrosis and MI defined by >3X elevation above ULN  Results of SUPPORT I suggest the basis for further study and a Phase III study design