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Oct 10, 2011

PCI for Late Reperfusion After Myocardial Infarction Continues Despite Negative OAT Trial: Less Is MoreComment on “Impact of National Clinical Guideline Recommendations for Revascularization of Persistently Occluded Infarct-Related Arteries on Clinical Practice in the United States”

Arch Intern Med. 2011;171(18):1645. doi:10.1001/archinternmed.2011.296

The Occluded Artery Trial (OAT) showed no benefit of percutaneous coronary intervention (PCI) for “late” reperfusion after acute myocardial infarction. The importance of this well-performed randomized trial was documented by an immediate change to professional society guidelines, which now classify this procedure as inappropriate. Yet, as documented by Deyell et al, the results of the trial and change in guidelines did not lead to a change in practice patterns. This article gets our “Less Is More” designation because it addresses a procedure that has no known benefit and definite risks.

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