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

2. 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)

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

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

5. In-Hospital Outcomes - STEMI *Unadjusted mortality ** Among non-CABG pts *Unadjusted mortality ** Among non-CABG pts ACTION Registry-GWTG DATA: January 1.2009 – December 31, 2009

6. 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

7. 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

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

9. 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

10. STEMI Door-to-Balloon Times – Median Times for Transfer In and Non-Transfer In Patients Transfer in DTB TimesNon-Transfer in DTB Times 96 123 159 49 63 79 Q1 09 96 117 147 48 61 77 Q2 09 92 112 142 48 62 Q3 09 91 113 143 48 62 76 Q4 09 Time (min) 50 220 210 60 70 80 90 110 100 120 130 140 150 160 170 200 180 190 240 230 77 40 30 20 250 10 0

11. 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

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

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

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

15. Baseline Characteristics - NSTEMI

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

17. 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

18. 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

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

20. 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

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

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

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

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

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

26. Baseline Characteristics – STEMI vs. NSTEMI

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

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

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

30. 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

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

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

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

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