Occluded Artery Trial

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OAT (for Occluded Artery Trial ) which is acronym of November 2006 at the annual congress of the American Heart Association presented and in The New England Journal of Medicine published study on the benefits of a cardiac catheter intervention after a heart attack . The study results refute the so-called open artery hypothesis that an open infarct vessel is in principle preferable to a closed one. In stable patients, routine catheter intervention to mechanically reopen a closed infarct vessel is not appropriate if more than two days have passed since the infarction.

background

So far it has not been clarified whether the mechanical reopening of a closed infarct vessel after the end of the acute phase reduces the risk of adverse events in high-risk patients.

Course of studies

A total of 2166 clinically stable patients were included in whom a complete occlusion of the infarct-related coronary artery was detected 3 to 28 days after a heart attack and who exhibited an impaired pumping function of the heart (left ventricular ejection fraction <50%) or a proximal occlusion as a risk characteristic . The patients were randomly treated either with balloon dilatation with stent implantation ( PCI ) of the infarct vessel and additional drug therapy (1082 patients) or only with drug therapy (1084 patients).

Results

The primary endpoint of the study, a combination of death, recurrent heart attack (reinfarction) or had heart failure on the severity of NYHA been set IV. After a mean of four years, it was 17.2% in the PCI group and 15.6% in the drug-only group (relative risk for the PCI group 1.16, p = 0.2). This statistically insignificant difference was exclusively due to a likewise insignificant higher number of re-infarctions (7.0 vs. 5.3%, p = 0.13), while deaths (9.1 vs. 9.4%) and severe cases Heart failure (4.4 vs. 4.5%) were equally common in both groups. The subgroup characteristics age, gender, affected coronary artery, ejection fraction, diabetes mellitus and time interval between infarction and study inclusion had no influence on the results.

swell

  1. ^ Hochman JS et al .: Coronary intervention for persistent occlusion after myocardial infarction . N Engl J Med (2006) 355: 2395-2407. PMID 17105759 .

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