This episode of JACC-Baran features a brief discussion on Kendrick Lamar and the history of racial discrimination in the United States. Then Hiroki Ueyama, MD, from Emory University discusses his study on P2Y12 inhibitor pre-treatment in NST-ACS using data from the Chest Pain-MI Registry. The study examines how guideline changes have influenced clinical practice, revealing a decline in pre-treatment rates, significant practice variations, and no major differences in outcomes except for longer hospital stays in CABG patients. Watch the video or listen as a podcast here, then check out the JACC article: https://www.jacc.org/doi/10.1016/j.jacc.2024.09.1227