6/28/23, 11:44 PM OAT Pathway Feedback Search Clinical Topics Home Studies OAT OAT Disease ST-elevation myocardial infarction Trial question What is the role of PCI in stable patients with occlusion of the infarct-related artery 3-28 days after myocardial infarction? Study design Multi-center Open label RCT Population Characteristics of study participants 22.0% female N = 2166 78.0% male 2166 patients (476 female, 1690 male) Inclusion criteria: stable patients who had total occlusion of the infarct-related artery 3 to 28 days after myocardial infarction and who met a high-risk criterion (an ejection fraction of < 50% or proximal occlusion) Key exclusion criteria: NYHA class III or IV HF, shock, a serum creatinine concentration > 2.5 mg/dL, angiographically significant left main or three-vessel coronary artery disease, angina at rest, and severe ischemia on stress testing Interventions N=1082 PCI (stent and optimal medical therapy) N=1084 medical therapy (conventional medical therapy alone) https://web.pathway.md/studies/recpjl2M37e6tLyPz 1/2 6/28/23, 11:44 PM OAT Pathway Primary outcome Death, myocardial infarction, or NYHA class IV heart failure at 4 years 17.2 % 17.2 15.6 12.9 % 8.6 % 4.3 % No significant difference 0.0 % Percutaneous coronary intervention Medical therapy No significant difference in death, myocardial infarction, or NYHA class IV HF at 4 years (17.2% vs. 15.6%; HR 1.16, 95% CI 0.92 to 1.45) Secondary outcomes No significant difference in myocardial infarction, both fatal and nonfatal (7% vs. 5.3%; HR 1.36, 95% CI 0.92 to 2) No significant difference in nonfatal reinfarction (6.9% vs. 5%; HR 1.44, 95% CI 0.96 to 2.16) Conclusion In stable patients who had total occlusion of the infarct-related artery 3 to 28 days after myocardial infarction and who met a high-risk criterion (an ejection fraction of < 50% or proximal occlusion), PCI was not superior to medical therapy with respect to death, myocardial infarction, or NYHA class IV HF at 4 years. Reference Hochman JS, Lamas GA, Buller CE et al. Coronary intervention for persistent occlusion after myocardial infarction. N Engl J Med. 2006 Dec 7;355(23):2395-407. Open reference URL https://web.pathway.md/studies/recpjl2M37e6tLyPz 2/2