The Occluded Artery Trial (OAT) is an NHLBI-funded international, multicenter, randomized trial testing the hypothesis that percutaneous coronary intervention with optimal medical therapy is superior in reducing clinical events compared to optimal medical therapy alone in stable, but high-risk, post-myocardial infarction patients. OAT patients have totally occluded infarct-related arteries 3-28 days after myocardial infarction (Ml) and at least one additional high risk feature, either reduced left ventricular function (ejection fraction <50%) or proximal coronary artery occlusion. Patients were randomized between 2000 and 2005 to either medical management or medical management plus percutaneous coronary intervention and stenting. The primary endpoint was a composite of death, class IV congestive heart failure (CHF) and recurrent Ml. After an average of three years of follow up of 2,166 enrolled patients, there was no significant difference between the treatment groups for the primary endpoint. This application for a competitive renewal proposes: A) to extend follow up by an additional 3 years to achieve an average follow up of approximately 6 years on the OAT cohort to examine late trends in events and quality of life and;B) to perform additional in-depth analyses on the original OAT cohort followed for 3 years. Extended follow up will also increase power to examine pre-specified subgroups. Extension of follow up in OAT is designed to provide the medical community with definitive data on the risks and benefits of a strategy of routine PCI of persistently occluded infarct-related arteries in stable patients late post-MI. OAT has over 200 participating clinical sites, a Clinical Coordinating Center at New York University Medical School, a Co-CCC at Mount Sinai Medical Center, a Data Coordinating Center at Maryland Medical Research Institute and a quality of Life Coordinating Center at Duke Clinical Research Institute.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
7U01HL062511-09
Application #
7876977
Study Section
Special Emphasis Panel (ZHL1-CSR-S (F3))
Program Officer
Goldberg, Suzanne H
Project Start
1999-09-30
Project End
2012-05-31
Budget Start
2010-06-15
Budget End
2012-05-31
Support Year
9
Fiscal Year
2010
Total Cost
$467,357
Indirect Cost
Name
Clinical Trials and Surveys Corporation
Department
Type
DUNS #
621075605
City
Owings Mills
State
MD
Country
United States
Zip Code
21117
Adlbrecht, Christopher; Huber, Kurt; Reynolds, Harmony R et al. (2014) Effects of timing, location and definition of reinfarction on mortality in patients with totally occluded infarct related arteries late after myocardial infarction. Int J Cardiol 174:90-5
Kruk, Mariusz; Menon, Venu; K?dziela, Jacek et al. (2013) Impact of percutaneous coronary intervention on biomarker levels in patients in the subacute phase following myocardial infarction: the Occluded Artery Trial (OAT) biomarker ancillary study. BMC Cardiovasc Disord 13:91
Menon, Venu; Ruzyllo, Witold; Carvalho, Antonio C et al. (2013) Infarct artery distribution and clinical outcomes in occluded artery trial subjects presenting with non-ST-segment elevation myocardial infarction (from the long-term follow-up of Occluded Artery Trial [OAT]). Am J Cardiol 111:930-5
Overgaard, Christopher B; Džavík, Vladimír; Buller, Christopher E et al. (2013) Percutaneous revascularization and long term clinical outcomes of diabetic patients randomized in the Occluded Artery Trial (OAT). Int J Cardiol 168:2416-22
Hastings, Ramin S; Hochman, Judith S; Dzavik, Vladimir et al. (2012) Effect of late revascularization of a totally occluded coronary artery after myocardial infarction on mortality rates in patients with renal impairment. Am J Cardiol 110:954-60
Freixa, Xavier; Dzavik, Vladimir; Forman, Sandra A et al. (2012) Long-term outcomes after a strategy of percutaneous coronary intervention of the infarct-related artery with drug-eluting stents or bare metal stents vs medical therapy alone in the Occluded Artery Trial (OAT). Am Heart J 163:1011-8
Reynolds, Harmony R; Forman, Sandra A; Tamis-Holland, Jacqueline E et al. (2012) Relationship of female sex to outcomes after myocardial infarction with persistent total occlusion of the infarct artery: analysis of the Occluded Artery Trial (OAT). Am Heart J 163:462-9
Jhaveri, Rahul R; Reynolds, Harmony R; Katz, Stuart D et al. (2012) Heart failure in post-mi patients with persistent ira occlusion: prevalence, risk factors, and the long-term effect of PCI in the Occluded Artery Trial (OAT). J Card Fail 18:813-21
Skolnick, Adam H; Reynolds, Harmony R; White, Harvey D et al. (2012) Comparison of late results of percutaneous coronary intervention among stable patients ?65 versus >65 years of age with an occluded infarct related artery (from the Occluded Artery Trial). Am J Cardiol 109:614-9
Devlin, Gerard; Reynolds, Harmony R; Mark, Daniel B et al. (2011) Loss of short-term symptomatic benefit in patients with an occluded infarct artery is unrelated to non-protocol revascularization: results from the Occluded Artery Trial (OAT). Am Heart J 161:84-90

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