OAT/ OAT Long Term Follow-Up: The Occluded Artery Trial
The OAT Trial and its Long Term Follow Up extension were NIH funded multicentered trials designed to test the hypothesis that opening an occluded infarct artery with percutaneous intervention, including stents, 3-28 days after an acute MI in asymptomatic patients who are at increased long term risk for events ( ejection fractions < 50% or a proximal occlusion of a large coronary artery) would reduce a composite endpoint of mortality, recurrent nonfatal MI and hosptialization for NYHA class IV CHF over 3 years ( average) of follow-up.Results for the intial trial have been well published.(N Engl J Med 2006; 355) Follow up continued for 5 years to obtain information on late outcomes. Data analysis for this extension is ongoing.
OAT was 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. 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.Secondary aims included comparison of medical costs of the two treatments ,health related quality of life of the two treatments and the individual components of the study composite primary endpoint of the two treatments. Long term follow up for 5 years to obtain late outocme data followed.
Patients with a confirmed MI with a completely occluded IRA (day 3-28), as well as high-risk criteria (ejection fraction < 50% and/or proximal occlusion of major epicardial vessel supplying > 25% of the left ventricle) were eligible. Exclusion criteria included left main or triple vessel disease, hemodynamic or electrical instability, rest or low-threshold angina, and NYHA class III-IV heart failure or shock
Kevin Marzo, M.D
Division of Cardiology
Wendy Drewes,RN,BSN 516-663-2929 firstname.lastname@example.org