Where does the Occluded Artery Trial leave the late open artery hypothesis?

Abstract

As of April 2007 the early open artery hypothesis is alive and well, but the late open artery hypothesis is adrift. For the foreseeable future, stable patients with persistent occlusion of the infarct artery late after myocardial infarction, and without severe ischaemia or uncontrollable angina, should be managed initially with optimal medical treatment alone, and not with percutaneous coronary intervention. Efforts should focus on establishing reperfusion earlier, including reducing the time to patient presentation.

Conflict of interest statement

Competing interests: Dr Lamas has received speaking fees from CV Therapeutics, Medtronic, Guidant and Bristol‐Myers Squibb, and consulting fees from CV Therapeutics and Medtronic. Dr Hochman has received consulting fees from Eli Lilly, Bristol‐Myers Squibb, Sanofi Aventis, and CV Therapeutics, speaking fees from the Network for Continuing Medical Education (supported by Bristol‐Myers Squibb and Sanofi Aventis) and grant support to her institution for this study from Eli Lilly, Millennium Pharmaceuticals, Schering‐Plough, Guidant, and Merck.

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