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Cited by 732

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Coronary Intervention for Persistent Occlusion after Myocardial Infarction

Open access
Hochman, Judith S., Lamas, Gervasio A., Buller, Christopher E., Dzavik, Vladimir, Reynolds, Harmony R., Abramsky, Staci J., Forman, Sandra, Ruzyllo, Witold, Maggioni, Aldo P., White, Harvey, Sadowski, Zygmunt, Carvalho, Antonio C., Rankin, Jamie M., Renkin, Jean P., Steg, P. Gabriel, Mascette, Alice M., Sopko, George, Pfisterer, Matthias E., Leor, Jonathan, Fridrich, Viliam, Mark, Daniel B., Knatterud, Genell L.·2006·New England Journal of Medicine
DOI 10.1056/nejmoa066139
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Abstract

BACKGROUND: It is unclear whether stable, high-risk patients with persistent total occlusion of the infarct-related coronary artery identified after the currently accepted period for myocardial salvage has passed should undergo percutaneous coronary intervention (PCI) in addition to receiving optimal medical therapy to reduce the risk of subsequent events. METHODS: We conducted a randomized study involving 2166 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). Of these patients, 1082 were assigned to routine PCI and stenting with optimal medical therapy, and 1084 were assigned to optimal medical therapy alone. The primary end point was a composite of death, myocardial reinfarction, or New York Heart Association (NYHA) class IV heart failure. RESULTS: The 4-year cumulative primary event rate was 17.2% in the PCI group and 15.6% in the medical therapy group (hazard ratio for death, reinfarction, or heart failure in the PCI group as compared with the medical therapy group, 1.16; 95% confidence interval [CI], 0.92 to 1.45; P=0.20). Rates of myocardial reinfarction (fatal and nonfatal) were 7.0% and 5.3% in the two groups, respectively (hazard ratio, 1.36; 95% CI, 0.92 to 2.00; P=0.13). Rates of nonfatal reinfarction were 6.9% and 5.0%, respectively (hazard ratio, 1.44; 95% CI, 0.96 to 2.16; P=0.08); only six reinfarctions (0.6%) were related to assigned PCI procedures. Rates of NYHA class IV heart failure (4.4% vs. 4.5%) and death (9.1% vs. 9.4%) were similar. There was no interaction between treatment effect and any subgroup variable (age, sex, race or ethnic group, infarct-related artery, ejection fraction, diabetes, Killip class, and the time from myocardial infarction to randomization). CONCLUSIONS: PCI did not reduce the occurrence of death, reinfarction, or heart failure, and there was a trend toward excess reinfarction during 4 years of follow-up in stable patients with occlusion of the infarct-related artery 3 to 28 days after myocardial infarction. (ClinicalTrials.gov number, NCT00004562 [ClinicalTrials.gov].).

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Metadata

Authors
Hochman, J. S., Lamas, G. A., Buller, C. E., Dzavik, V., Reynolds, H. R., Abramsky, S. J., Forman, S., Ruzyllo, W., Maggioni, A. P., White, H., Sadowski, Z., Carvalho, A. C., Rankin, J. M., Renkin, J. P., Steg, P. G., Mascette, A. M., Sopko, G., Pfisterer, M. E., Leor, J., Fridrich, V., Mark, D. B., & Knatterud, G. L.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2006-12-07
Volume
355
Issue
23
Pages
2395-2407
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa066139
OpenAlex
W2094494009
Cited by
732
References
2
FWCI
69.82
Type
journal article
Language
en
Open access
bronze

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