The Occluded Artery Trial assessed percutaneous coronary intervention in addition to optimal medical therapy in patients with persistent total occlusion of the infarct-related artery.
Results: The 4-year centrally adjudicated event rate was 17.2% for the PCI plus medical therapy group (n = 1,082) vs. 15.6% for the medical therapy only group (n = 1,084) (HR for death, reinfarction or heart failure = 1.16; 95% CI, 0.92-1.45). Myocardial infarction rates, both fatal and non-fatal, were 7% in the PCI plus medical therapy group vs. 5.3% in the medical therapy only group (HR = 1.36; 95% CI, 0.92-2); rates of nonfatal reinfarction were 6.9% and 5%, respectively (HR = 1.44; 95% CI, 0.96-2.16). Only six reinfarctions were related to PCI. Between-group rates of New York Heart Association Functional Class IV Heart Failure and death were similar (4.4% vs. 4.5% and 9.1% vs. 9.4%, respectively).
Hochman JS, et al. N Engl J Med. 2006;10.1056/NEJMoa066139.
Healio/Cardiology News Coverage:
OAT: Medical therapy without late PCI worked for those not at highest risk