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INTERVENTIONAL CARDIOLOGY
A third of patients hospitalised with an acute myocardial infarction (MI) have persistent occlusion of the infarct related artery at 72 h, despite the availability of several effective reperfusion strategies. This has led to interest as to whether some of the benefits seen with early opening of the artery could be achieved with later opening, the so called "open artery hypothesis". It is thought that late opening of occluded infarct related arteries after acute MI may improve survival (through lower risks of heart failure and sudden death from cardiac causes), ventricular function (revascularisation of hibernating myocardium and improved remodelling) and quality of life. To assess this hypothesis, the Occluded Artery Trial (OAT) compared percutaneous coronary intervention (PCI) with medical treatment alone in 2166 patients who had an occluded infarct-related artery 3–28 days after an MI, and found no evidence of clinical benefit from late arterial opening. This paper reports the
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