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Delayed angioplasty -- big bucks, no bang
Date:11/5/2007

ORLANDO, FL In a subset of patients suffering heart attack, adding stents to clot-busting medical therapy after the optimal treatment window ends isn't justified, say researchers from Duke University Medical Center.

In a follow-up to last year's widely reported Occluded Artery Trial (OAT), which reported that catheterization didn't seem to prevent second heart attacks if it were used more than 3 days after the initial heart attack, a group of Duke researchers looked more closely at 951 patients to see if there were other benefits from the procedure.

Their findings were presented today at a late-breaking trials session of the American Heart Associations annual meeting in Orlando.

Each year, about one million people suffer heart attacks in the United States, and studies suggest that for many of them, the best treatment is speedy use of clot-busting drugs or percutaneous coronary intervention (PCI), a catheter-based procedure that uses stents and balloons to open up blocked arteries. Ideally, the procedures should begin within 12 hours of the initial attack. But in real life, that doesnt always happen because patients delay seeking help and arrive at emergency departments too late for timely care.

Last year, OAT researchers who had followed 2,166 heart attack patients for up to five years told the American Heart Association annual meeting that PCI applied 3 to 28 days after the initial attack apparently didnt make any long-term difference in preventing second heart attacks, death, or development of heart failure.

All participants in OAT had experienced heart attacks, were considered high-risk, but were stable with one completely blocked artery. All of the patients received state-of-the-art drug therapy, but half also got the late PCI.

Focusing on a representative subset of 951 patients in the OAT trial, Dr. Daniel Mark, a cardiologist and director of outcomes research at the Duke Clinical Research Instit
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Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-724-5343
Duke University Medical Center
Source:Eurekalert

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