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Percutaneous coronary intervention in the Occluded Artery Trial : procedural success, hazard, and outcomes over 5 years

Buller, Christopher E. and Rankin, Jamie M. and Carere, Ronald G. and Buszman, Pawel E. and Pfisterer, Matthias E. and Dzavik, Vladimir and Thomas, Boban and Forman, Sandra and Ruzyllo, Witold and Mancini, G. B. John and Michalis, Lampros K. and Abreu, Pedro F. and Lamas, Gervasio A. and Hochman, Judith S.. (2009) Percutaneous coronary intervention in the Occluded Artery Trial : procedural success, hazard, and outcomes over 5 years. American heart journal : an international publication for the study of the circulation, Vol. 158. pp. 408-415.

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Official URL: http://edoc.unibas.ch/dok/A6005010

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Abstract

BACKGROUND: The Occluded Artery Trial (OAT) was a 2,201-patient randomized clinical trial comparing routine stent-based percutaneous coronary intervention (PCI) versus optimal medical therapy alone in stable myocardial infarction (MI) survivors with persistent infarct-related artery occlusion identified day 3 to 28 post MI. Intent-to-treat analysis showed no difference between strategies with respect to the incidence of new class IV congestive heart failure, MI, or death. The influence of PCI failure, procedural hazard, and crossover on trial results has not been reported. METHODS: Study angiograms were analyzed and adjudicated centrally. Factors associated with PCI failure were examined. Time-to-event analysis using the OAT primary outcome was performed by PCI success status. Landmark analysis (up to and beyond 30 days) partitioned early hazard versus late outcome according to treatment received. RESULTS: Percutaneous coronary intervention was adjudicated successful in <87%. Percutaneous coronary intervention failure rates were similar in US and non-US sites, and did not significantly influence outcome at 60 months (hazard ratio for success vs fail 0.79, 99% CI 0.45-1.40, P = .29). Partitioning of early procedural hazard revealed no late benefit for PCI (hazard ratio for PCI success vs medical therapy alone 1.06, 99% CI 0.75-1.50, P = .66). CONCLUSIONS: Percutaneous coronary intervention failure and complication rates in the OAT were low. Neither PCI failure nor early procedural hazard substantively influenced the primary trial results.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Kardiologie (Pfisterer)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Kardiologie (Pfisterer)
UniBasel Contributors:Pfisterer, Matthias E.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:C.V. Mosby
ISSN:0002-8703
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:22
Deposited On:24 May 2013 09:02

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