In this context, the present analysis adds important new information to the literature. Our findings suggest shorter total door-to-balloon times in transfer patients during the intervening few years (i.e., 152 min vs. 180 min). However, we also found that many patients still have marked delays in total door-to-balloon times and that few reach the benchmark established by national guidelines. Compared with the previous analysis, total door-to-balloon times were shorter because of more rapid door-to-door times (109 min vs. 120 min) and PCI hospital door-to-balloon times (38 min vs. 53 min). Of course, any direct comparisons between the present and previous analyses should be done with caution, owing to the involvement of different hospitals and types of patients between registries. The present analysis, for example, included more nonurban hospitals as well as patients with cardiogenic shock. Finally, it is important to note that these hospitals participated voluntarily in the CathPCI registry, a national quality improvement registry. These hospitals therefore may present a “best”-case scenario for transfer patients.