1. Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries J Am Coll Cardiol. 2016;67(20):2378-2391. doi:10.1016/j.jacc.2016.03.507 Flow Diagram of Study Inclusion Criteria Separate eligibility criteria were used for each guideline. “Ideal candidates” were defined as being eligible for a particular therapy without specific contraindications per American Heart Association/American College of Cardiology guidelines. AMI = acute myocardial infarction. Figure Legend:

2. Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries J Am Coll Cardiol. 2016;67(20):2378-2391. doi:10.1016/j.jacc.2016.03.507 Expected Survival Curves for Those Receiving and Not Receiving Guideline-Based Therapies Expected survival curves for those receiving and not receiving aspirin within 48 h (A), beta-blockers within 48 h (B), acute reperfusion therapy within 12 h (C), door-to-balloon within 90 min (D), and door-to-needle therapy within 30 min (E), among those eligible for these therapies. Unadjusted survival curves were calculated using Cox proportional hazards models with only therapy receipt included in the model statement. Survival curves of therapy recipients (orange line) and nonrecipients (blue line) separated early after admission and remained distinct over the entire duration of follow-up. In all cases, therapy recipients had significantly higher survival than nonrecipients. Figure Legend:

3. Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries J Am Coll Cardiol. 2016;67(20):2378-2391. doi:10.1016/j.jacc.2016.03.507 Age-Specific Absolute and Relative Numbers of Life-Years Saved Age-specific absolute and relative numbers of life-years saved from aspirin (A), beta-blockers (B), and acute reperfusion therapy (C) after myocardial infarction. Numbers of life-years saved were calculated using marginal Cox proportional hazards models with extrapolation using exponential models. Analyses have been adjusted for patient demographics (sex, age, race, ZIP code–level median household income percentile), medical history (hypertension, diabetes, previous coronary artery disease, chronic heart failure, cerebrovascular accident, chronic obstructive pulmonary disease, chronic kidney disease, current smoking, obesity, cancer, dementia, anemia), frailty measures (admission from a skilled nursing facility, mobility and urinary continence on admission), clinical presentation (Killip class >2, anterior acute myocardial infarction [AMI], pulse and systolic blood pressure on admission, ST- segment elevation myocardial infarction, cardiac arrest), receipt of other therapies (aspirin, beta-blockers, and acute reperfusion therapy), and hospital characteristics (AMI volume per year, rural location, hospital ownership, and teaching status). Figure Legend:

4. Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries J Am Coll Cardiol. 2016;67(20):2378-2391. doi:10.1016/j.jacc.2016.03.507 Years of Life Lost Associated With Increasing D2B and D2N Time Years of life lost by patients with longer door-to-balloon (D2B) (A) and door-to-needle (D2N) (B) times are calculated in reference to patients with D2B times ≤90 min and D2N times ≤30 min, respectively. Analyses have been adjusted for patient demographics (sex, age, race, ZIP code–level median household income percentile), medical history (hypertension, diabetes, previous coronary artery disease, chronic heart failure, cerebrovascular accident, chronic obstructive pulmonary disease, chronic kidney disease, current smoking, obesity, cancer, dementia, anemia), frailty measures (admission from a skilled nursing facility, mobility and urinary continence on admission), clinical presentation (Killip class >2, anterior acute myocardial infarction [AMI], pulse and systolic blood pressure on admission, ST-segment elevation myocardial infarction, cardiac arrest), receipt of other therapies (aspirin, beta- blockers, and acute reperfusion therapy), and hospital characteristics (AMI volume per year, rural location, hospital ownership, and teaching status). Figure Legend:

5. Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries J Am Coll Cardiol. 2016;67(20):2378-2391. doi:10.1016/j.jacc.2016.03.507 AMI Admission Therapies and Life Expectancy: Average Number of Life-Years Saved Prior studies have invariably evaluated improvements in short-term outcomes due to acute myocardial infarction (AMI) guideline- based therapies. In this study, we quantified life expectancy after AMI and the number of life-years saved by these therapies. Cox proportional hazards regression with extrapolation using exponential models were used to calculate the number of life-years saved attributable to these therapies. All 5 therapies were associated with substantial numbers of life-years saved on average in elderly AMI patients, illustrating the importance of early and rapid delivery of these therapies. Figure Legend: