Please select the eligibility criteria that correspond to the clinical trial below.
Title: Brazilian Intervention to Increase Evidence Usage in Practice - Acute Coronary Syndromes
Brief Summary: Phase 1: An observational study (registry) will be conducted which will objectively document the ACS clinical practice in Brazilian public hospitals, and identify the important barriers for the evidence usage incorporation in the clinical practice.

Phase 2: A Cluster randomized clinical trial in which public hospital will be randomized to receive or not a multifaceted strategy in order to increase evidence based therapy in clinical practice.


Options:
A: Inclusion Criteria:

* Recent myocardial infarction (within 3 months after the index event)
* Standard rehabilitation program of 3-6 weeks performed
* Informed consent (obtained before any study specific procedure)

Exclusion Criteria:

* Age \> 75 years
* Any condition that in the opinion of the investigator would jeopardize the evaluation of efficacy or be associated with poor adherence to the protocol;
* Presence of any non-cardiac disease (e.g. cancer) that is likely to significantly shorten life expectancy
B: Patient Eligibility criteria

Inclusion Criteria:

* Patients with thoracic pain who the emergency department physician suspects of ACS and plans start a treatment for this issue

Exclusion Criteria:

* Patients transferred from others institutions within 12 hours of the symptoms

Cluster Eligibility Criteria

* National Public Hospitals with emergency department. A cluster can be one hospital with emergency department, or 2 or more hospitals (for example: 1 emergency hospital and 1 general hospital which receive the patients to perform PCI).
C: Inclusion Criteria:

* Admitted to Duke University Medical Center (DUMC) with both the diagnosis of acute MI (ICD code 410.01-410.91) and hypertension (ICD-9 code 401.X or clinical diagnosis)
* A cardiac catheterization at DUMC within the past 3 years
* Age \> 18 years
* Established or planned follow-up with a primary care/cardiology provider within the Duke University Health System or its Affiliated Clinics

Exclusion Criteria:

Medical Records Exclusion (occurs prior to mailing invitation):

* Diagnosis of metastatic cancer in the past 6 months
* Active diagnosis of psychosis or dementia
* Currently receiving hemodialysis
* Patients who have had a transplant

Patient-Level Exclusion (occurs at initial interview):

* Does not have access to a telephone
* Does not have access to a computer
* Refusal to provide informed consent
* Resident in nursing home or receiving home health care
* Severely impaired hearing or speech (patients must be able to respond to phone calls)
* Participating in another study (i.e., pharmaceutical trial)
* NYHA class IV heart failure
* Does not plan to have long-term follow-up with a primary care provider cardiologist
D: Inclusion Criteria:

* Age 20 to 80 years
* English Proficiency
* Internet Access (home or work)
* Documented CAD (most recent cardiac diagnosis); documented Myocardial Infarction (MI), successful PCI procedure

Exclusion Criteria:

* Patient intends to enroll in structured cardiac rehabilitation
* Hospitalization for Coronary Artery Bypass (CABG)
* Hospitalization for diagnostic procedure not associated with previously documented MI
* Patient coming back to hospital for planned staged PCI within 6 months
* Cardiac transplantation
* Presence of, or hospitalization for defibrillator implant
* Hospitalization for pacemaker implantation
* Unresolved unstable angina \&/or hospitalization for angina (without MI or PCI)
* Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
* Neuromuscular, musculoskeletal or rheumatoid disorders that are exacerbated by exercise
* Other uncontrolled metabolic conditions (e.g. diabetes)
* Chronic infectious diseases such as mononucleosis, hepatitis, AIDS
* Acute systematic illness or fever
* Uncontrolled tachycardia (\<120 bpm)
* Uncompensated congestive heart failure (\&/or NYHA Class III, or IV)
* 3rd degree AV block without pacemaker
* Active pericarditis or myocarditis
* Recent embolism
* Suspected or known AAA aneurysm \> 4cm
* Uncontrolled hypertension (SBP \> 200; DBP \> 110)
* Pregnancy

Answer: B