Loading…
Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial
In the present study, we sought to determine whether opening a persistently occluded infarct-related artery (IRA) by percutaneous coronary intervention (PCI) in patients beyond the acute phase of myocardial infarction (MI) improves patency and indices of left ventricular (LV) size and function. Betw...
Saved in:
| Published in: | Circulation (New York, N.Y.) N.Y.), 2006-12, Vol.114 (23), p.2449-2457 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c412t-50fdf51bb7ea754ad2572b81a4ad4a69dfe72b3d3c2d4618dc96776644d676dc3 |
| container_end_page | 2457 |
| container_issue | 23 |
| container_start_page | 2449 |
| container_title | Circulation (New York, N.Y.) |
| container_volume | 114 |
| creator | DZAVIK, Vladimir BULLER, Christopher E THOMAS, Boban BUSZMAN, Pawel VOZZI, Carlos GLANZ, Anthony COHEN, Eric A MECIAR, Peter DEVLIN, Gerald MASCETTE, Alice SOPKO, George KNATTERUD, Genell L LAMAS, Gervasio A HOCHMAN, Judith S RANKIN, James M MANCINI, G. B. John CANTOR, Warren J CARERE, Ronald J ROSS, John R ATCHISON, Deborah FORMAN, Sandra |
| description | In the present study, we sought to determine whether opening a persistently occluded infarct-related artery (IRA) by percutaneous coronary intervention (PCI) in patients beyond the acute phase of myocardial infarction (MI) improves patency and indices of left ventricular (LV) size and function.
Between May 2000 and July 2005, 381 patients with an occluded native IRA 3 to 28 days after MI (median 10 days) were randomized to PCI with stenting (PCI) or optimal medical therapy alone. Repeat coronary and LV angiography was performed 1 year after randomization (n=332, 87%). Coprimary end points were IRA patency and change in LV ejection fraction. Secondary end points included change in LV end-systolic and end-diastolic volume indices and wall motion. PCI was successful in 92%. At 1 year, 83% of PCI versus 25% of medical therapy-only patients had a patent IRA (P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.106.669432 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2785021</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68217456</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-50fdf51bb7ea754ad2572b81a4ad4a69dfe72b3d3c2d4618dc96776644d676dc3</originalsourceid><addsrcrecordid>eNpVUsuO0zAUjRCIKQO_gMwCBIuU2PEjYYFURcBUqqg0dNbRre1MjRK72E6l8rf8CQ6tOszKj_O499ony97gYo4xxx-b5W1zt1psluvvi5vFHBd8znlNS_Ikm2FGaE5ZWT_NZkVR1LkoCbnKXoTwMx15Kdjz7AoLXLCKVrPszy1Y5QbzWysUvYEeuQ7ttZdjBKvdGJB03lnwR2Rs1P6gbTTOos55FMYtJJ5OSAdextzrHmIyukjAJ8kROSn7MUyy6BDIndEHjXpn7_MED2ifRFYmtlXIDHvvEjrV8UaOPXjUjVb-K_oJbXY6ecSpzYtniKM6Tm03YEEBer9Z_2gWH3JyGuhl9qyDPuhX5_U6u_v6ZdPc5Kv1t2WzWOWSYhJzVnSqY3i7FRoEo6AIE2RbYUhbCrxWnU7nUpWSKMpxpWTNheCcUsUFV7K8zj6ffPfjdtBKTgNA3-69GdJTtA5M-xixZtfeu0NLRMUKgpPBu7OBd79GHWI7mCB1358-ouUVwYIynoj1iSi9C8Hr7lIEF-0UkPZxQNI1b08BSdrX_3f5oDwnIhHengkQJPSdBytNeOBVJSOCi_IvUtvN7A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68217456</pqid></control><display><type>article</type><title>Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial</title><source>EZB Electronic Journals Library</source><creator>DZAVIK, Vladimir ; BULLER, Christopher E ; THOMAS, Boban ; BUSZMAN, Pawel ; VOZZI, Carlos ; GLANZ, Anthony ; COHEN, Eric A ; MECIAR, Peter ; DEVLIN, Gerald ; MASCETTE, Alice ; SOPKO, George ; KNATTERUD, Genell L ; LAMAS, Gervasio A ; HOCHMAN, Judith S ; RANKIN, James M ; MANCINI, G. B. John ; CANTOR, Warren J ; CARERE, Ronald J ; ROSS, John R ; ATCHISON, Deborah ; FORMAN, Sandra</creator><creatorcontrib>DZAVIK, Vladimir ; BULLER, Christopher E ; THOMAS, Boban ; BUSZMAN, Pawel ; VOZZI, Carlos ; GLANZ, Anthony ; COHEN, Eric A ; MECIAR, Peter ; DEVLIN, Gerald ; MASCETTE, Alice ; SOPKO, George ; KNATTERUD, Genell L ; LAMAS, Gervasio A ; HOCHMAN, Judith S ; RANKIN, James M ; MANCINI, G. B. John ; CANTOR, Warren J ; CARERE, Ronald J ; ROSS, John R ; ATCHISON, Deborah ; FORMAN, Sandra ; TOSCA-2 Investigators</creatorcontrib><description>In the present study, we sought to determine whether opening a persistently occluded infarct-related artery (IRA) by percutaneous coronary intervention (PCI) in patients beyond the acute phase of myocardial infarction (MI) improves patency and indices of left ventricular (LV) size and function.
Between May 2000 and July 2005, 381 patients with an occluded native IRA 3 to 28 days after MI (median 10 days) were randomized to PCI with stenting (PCI) or optimal medical therapy alone. Repeat coronary and LV angiography was performed 1 year after randomization (n=332, 87%). Coprimary end points were IRA patency and change in LV ejection fraction. Secondary end points included change in LV end-systolic and end-diastolic volume indices and wall motion. PCI was successful in 92%. At 1 year, 83% of PCI versus 25% of medical therapy-only patients had a patent IRA (P<0.001). LV ejection fraction increased significantly (P<0.001) in both groups, with no between-group difference: PCI 4.2+/-8.9 (n=150) versus medical therapy 3.5+/-8.2 (n=136; P=0.47). Median change (interquartile range) in LV end-systolic volume index was -0.5 (-9.3 to 5.0) versus 1.0 (-5.7 to 7.3) mL/m2 (P=0.10), whereas median change (interquartile range) in LV end-diastolic volume index was 3.2 (-8.2 to 13.3) versus 5.3 (-4.6 to 23.2) mL/m2 (P=0.07) in the PCI (n=86) and medical therapy-only (n=76) groups, respectively.
PCI with stenting of a persistently occluded IRA in the subacute phase after MI effectively maintains long-term patency but has no effect on LV ejection fraction. On the basis of these findings and the lack of clinical benefit in the main Occluded Artery Trial, routine PCI is not recommended for stable patients with a persistently occluded IRA after MI.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.106.669432</identifier><identifier>PMID: 17105848</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary - methods ; Biological and medical sciences ; Blood and lymphatic vessels ; Canada ; Cardiology. Vascular system ; Cardiovascular system ; Coronary Artery Disease - etiology ; Coronary Artery Disease - physiopathology ; Coronary Artery Disease - therapy ; Coronary heart disease ; Disease Progression ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Endpoint Determination ; Female ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - complications ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardial Revascularization ; Pharmacology. Drug treatments ; Stents ; Stroke Volume - physiology ; Treatment Outcome ; Vascular Patency - physiology ; Vasodilator agents. Cerebral vasodilators ; Ventricular Function, Left - physiology</subject><ispartof>Circulation (New York, N.Y.), 2006-12, Vol.114 (23), p.2449-2457</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c412t-50fdf51bb7ea754ad2572b81a4ad4a69dfe72b3d3c2d4618dc96776644d676dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18352767$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17105848$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DZAVIK, Vladimir</creatorcontrib><creatorcontrib>BULLER, Christopher E</creatorcontrib><creatorcontrib>THOMAS, Boban</creatorcontrib><creatorcontrib>BUSZMAN, Pawel</creatorcontrib><creatorcontrib>VOZZI, Carlos</creatorcontrib><creatorcontrib>GLANZ, Anthony</creatorcontrib><creatorcontrib>COHEN, Eric A</creatorcontrib><creatorcontrib>MECIAR, Peter</creatorcontrib><creatorcontrib>DEVLIN, Gerald</creatorcontrib><creatorcontrib>MASCETTE, Alice</creatorcontrib><creatorcontrib>SOPKO, George</creatorcontrib><creatorcontrib>KNATTERUD, Genell L</creatorcontrib><creatorcontrib>LAMAS, Gervasio A</creatorcontrib><creatorcontrib>HOCHMAN, Judith S</creatorcontrib><creatorcontrib>RANKIN, James M</creatorcontrib><creatorcontrib>MANCINI, G. B. John</creatorcontrib><creatorcontrib>CANTOR, Warren J</creatorcontrib><creatorcontrib>CARERE, Ronald J</creatorcontrib><creatorcontrib>ROSS, John R</creatorcontrib><creatorcontrib>ATCHISON, Deborah</creatorcontrib><creatorcontrib>FORMAN, Sandra</creatorcontrib><creatorcontrib>TOSCA-2 Investigators</creatorcontrib><title>Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>In the present study, we sought to determine whether opening a persistently occluded infarct-related artery (IRA) by percutaneous coronary intervention (PCI) in patients beyond the acute phase of myocardial infarction (MI) improves patency and indices of left ventricular (LV) size and function.
Between May 2000 and July 2005, 381 patients with an occluded native IRA 3 to 28 days after MI (median 10 days) were randomized to PCI with stenting (PCI) or optimal medical therapy alone. Repeat coronary and LV angiography was performed 1 year after randomization (n=332, 87%). Coprimary end points were IRA patency and change in LV ejection fraction. Secondary end points included change in LV end-systolic and end-diastolic volume indices and wall motion. PCI was successful in 92%. At 1 year, 83% of PCI versus 25% of medical therapy-only patients had a patent IRA (P<0.001). LV ejection fraction increased significantly (P<0.001) in both groups, with no between-group difference: PCI 4.2+/-8.9 (n=150) versus medical therapy 3.5+/-8.2 (n=136; P=0.47). Median change (interquartile range) in LV end-systolic volume index was -0.5 (-9.3 to 5.0) versus 1.0 (-5.7 to 7.3) mL/m2 (P=0.10), whereas median change (interquartile range) in LV end-diastolic volume index was 3.2 (-8.2 to 13.3) versus 5.3 (-4.6 to 23.2) mL/m2 (P=0.07) in the PCI (n=86) and medical therapy-only (n=76) groups, respectively.
PCI with stenting of a persistently occluded IRA in the subacute phase after MI effectively maintains long-term patency but has no effect on LV ejection fraction. On the basis of these findings and the lack of clinical benefit in the main Occluded Artery Trial, routine PCI is not recommended for stable patients with a persistently occluded IRA after MI.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Canada</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary heart disease</subject><subject>Disease Progression</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardial Revascularization</subject><subject>Pharmacology. Drug treatments</subject><subject>Stents</subject><subject>Stroke Volume - physiology</subject><subject>Treatment Outcome</subject><subject>Vascular Patency - physiology</subject><subject>Vasodilator agents. Cerebral vasodilators</subject><subject>Ventricular Function, Left - physiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNpVUsuO0zAUjRCIKQO_gMwCBIuU2PEjYYFURcBUqqg0dNbRre1MjRK72E6l8rf8CQ6tOszKj_O499ony97gYo4xxx-b5W1zt1psluvvi5vFHBd8znlNS_Ikm2FGaE5ZWT_NZkVR1LkoCbnKXoTwMx15Kdjz7AoLXLCKVrPszy1Y5QbzWysUvYEeuQ7ttZdjBKvdGJB03lnwR2Rs1P6gbTTOos55FMYtJJ5OSAdextzrHmIyukjAJ8kROSn7MUyy6BDIndEHjXpn7_MED2ifRFYmtlXIDHvvEjrV8UaOPXjUjVb-K_oJbXY6ecSpzYtniKM6Tm03YEEBer9Z_2gWH3JyGuhl9qyDPuhX5_U6u_v6ZdPc5Kv1t2WzWOWSYhJzVnSqY3i7FRoEo6AIE2RbYUhbCrxWnU7nUpWSKMpxpWTNheCcUsUFV7K8zj6ffPfjdtBKTgNA3-69GdJTtA5M-xixZtfeu0NLRMUKgpPBu7OBd79GHWI7mCB1358-ouUVwYIynoj1iSi9C8Hr7lIEF-0UkPZxQNI1b08BSdrX_3f5oDwnIhHengkQJPSdBytNeOBVJSOCi_IvUtvN7A</recordid><startdate>20061205</startdate><enddate>20061205</enddate><creator>DZAVIK, Vladimir</creator><creator>BULLER, Christopher E</creator><creator>THOMAS, Boban</creator><creator>BUSZMAN, Pawel</creator><creator>VOZZI, Carlos</creator><creator>GLANZ, Anthony</creator><creator>COHEN, Eric A</creator><creator>MECIAR, Peter</creator><creator>DEVLIN, Gerald</creator><creator>MASCETTE, Alice</creator><creator>SOPKO, George</creator><creator>KNATTERUD, Genell L</creator><creator>LAMAS, Gervasio A</creator><creator>HOCHMAN, Judith S</creator><creator>RANKIN, James M</creator><creator>MANCINI, G. B. John</creator><creator>CANTOR, Warren J</creator><creator>CARERE, Ronald J</creator><creator>ROSS, John R</creator><creator>ATCHISON, Deborah</creator><creator>FORMAN, Sandra</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20061205</creationdate><title>Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial</title><author>DZAVIK, Vladimir ; BULLER, Christopher E ; THOMAS, Boban ; BUSZMAN, Pawel ; VOZZI, Carlos ; GLANZ, Anthony ; COHEN, Eric A ; MECIAR, Peter ; DEVLIN, Gerald ; MASCETTE, Alice ; SOPKO, George ; KNATTERUD, Genell L ; LAMAS, Gervasio A ; HOCHMAN, Judith S ; RANKIN, James M ; MANCINI, G. B. John ; CANTOR, Warren J ; CARERE, Ronald J ; ROSS, John R ; ATCHISON, Deborah ; FORMAN, Sandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-50fdf51bb7ea754ad2572b81a4ad4a69dfe72b3d3c2d4618dc96776644d676dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Canada</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Coronary Artery Disease - etiology</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary heart disease</topic><topic>Disease Progression</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardial Revascularization</topic><topic>Pharmacology. Drug treatments</topic><topic>Stents</topic><topic>Stroke Volume - physiology</topic><topic>Treatment Outcome</topic><topic>Vascular Patency - physiology</topic><topic>Vasodilator agents. Cerebral vasodilators</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DZAVIK, Vladimir</creatorcontrib><creatorcontrib>BULLER, Christopher E</creatorcontrib><creatorcontrib>THOMAS, Boban</creatorcontrib><creatorcontrib>BUSZMAN, Pawel</creatorcontrib><creatorcontrib>VOZZI, Carlos</creatorcontrib><creatorcontrib>GLANZ, Anthony</creatorcontrib><creatorcontrib>COHEN, Eric A</creatorcontrib><creatorcontrib>MECIAR, Peter</creatorcontrib><creatorcontrib>DEVLIN, Gerald</creatorcontrib><creatorcontrib>MASCETTE, Alice</creatorcontrib><creatorcontrib>SOPKO, George</creatorcontrib><creatorcontrib>KNATTERUD, Genell L</creatorcontrib><creatorcontrib>LAMAS, Gervasio A</creatorcontrib><creatorcontrib>HOCHMAN, Judith S</creatorcontrib><creatorcontrib>RANKIN, James M</creatorcontrib><creatorcontrib>MANCINI, G. B. John</creatorcontrib><creatorcontrib>CANTOR, Warren J</creatorcontrib><creatorcontrib>CARERE, Ronald J</creatorcontrib><creatorcontrib>ROSS, John R</creatorcontrib><creatorcontrib>ATCHISON, Deborah</creatorcontrib><creatorcontrib>FORMAN, Sandra</creatorcontrib><creatorcontrib>TOSCA-2 Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DZAVIK, Vladimir</au><au>BULLER, Christopher E</au><au>THOMAS, Boban</au><au>BUSZMAN, Pawel</au><au>VOZZI, Carlos</au><au>GLANZ, Anthony</au><au>COHEN, Eric A</au><au>MECIAR, Peter</au><au>DEVLIN, Gerald</au><au>MASCETTE, Alice</au><au>SOPKO, George</au><au>KNATTERUD, Genell L</au><au>LAMAS, Gervasio A</au><au>HOCHMAN, Judith S</au><au>RANKIN, James M</au><au>MANCINI, G. B. John</au><au>CANTOR, Warren J</au><au>CARERE, Ronald J</au><au>ROSS, John R</au><au>ATCHISON, Deborah</au><au>FORMAN, Sandra</au><aucorp>TOSCA-2 Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2006-12-05</date><risdate>2006</risdate><volume>114</volume><issue>23</issue><spage>2449</spage><epage>2457</epage><pages>2449-2457</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>In the present study, we sought to determine whether opening a persistently occluded infarct-related artery (IRA) by percutaneous coronary intervention (PCI) in patients beyond the acute phase of myocardial infarction (MI) improves patency and indices of left ventricular (LV) size and function.
Between May 2000 and July 2005, 381 patients with an occluded native IRA 3 to 28 days after MI (median 10 days) were randomized to PCI with stenting (PCI) or optimal medical therapy alone. Repeat coronary and LV angiography was performed 1 year after randomization (n=332, 87%). Coprimary end points were IRA patency and change in LV ejection fraction. Secondary end points included change in LV end-systolic and end-diastolic volume indices and wall motion. PCI was successful in 92%. At 1 year, 83% of PCI versus 25% of medical therapy-only patients had a patent IRA (P<0.001). LV ejection fraction increased significantly (P<0.001) in both groups, with no between-group difference: PCI 4.2+/-8.9 (n=150) versus medical therapy 3.5+/-8.2 (n=136; P=0.47). Median change (interquartile range) in LV end-systolic volume index was -0.5 (-9.3 to 5.0) versus 1.0 (-5.7 to 7.3) mL/m2 (P=0.10), whereas median change (interquartile range) in LV end-diastolic volume index was 3.2 (-8.2 to 13.3) versus 5.3 (-4.6 to 23.2) mL/m2 (P=0.07) in the PCI (n=86) and medical therapy-only (n=76) groups, respectively.
PCI with stenting of a persistently occluded IRA in the subacute phase after MI effectively maintains long-term patency but has no effect on LV ejection fraction. On the basis of these findings and the lack of clinical benefit in the main Occluded Artery Trial, routine PCI is not recommended for stable patients with a persistently occluded IRA after MI.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17105848</pmid><doi>10.1161/CIRCULATIONAHA.106.669432</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 2006-12, Vol.114 (23), p.2449-2457 |
| issn | 0009-7322 1524-4539 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2785021 |
| source | EZB Electronic Journals Library |
| subjects | Adult Aged Aged, 80 and over Angioplasty, Balloon, Coronary - methods Biological and medical sciences Blood and lymphatic vessels Canada Cardiology. Vascular system Cardiovascular system Coronary Artery Disease - etiology Coronary Artery Disease - physiopathology Coronary Artery Disease - therapy Coronary heart disease Disease Progression Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Endpoint Determination Female Heart Humans Male Medical sciences Middle Aged Myocardial Infarction - complications Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocardial Revascularization Pharmacology. Drug treatments Stents Stroke Volume - physiology Treatment Outcome Vascular Patency - physiology Vasodilator agents. Cerebral vasodilators Ventricular Function, Left - physiology |
| title | Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function : The total occlusion study of Canada (TOSCA)-2 trial |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T00%3A59%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Randomized%20trial%20of%20percutaneous%20coronary%20intervention%20for%20subacute%20infarct-related%20coronary%20artery%20occlusion%20to%20achieve%20long-term%20patency%20and%20improve%20ventricular%20function%20:%20The%20total%20occlusion%20study%20of%20Canada%20(TOSCA)-2%20trial&rft.jtitle=Circulation%20(New%20York,%20N.Y.)&rft.au=DZAVIK,%20Vladimir&rft.aucorp=TOSCA-2%20Investigators&rft.date=2006-12-05&rft.volume=114&rft.issue=23&rft.spage=2449&rft.epage=2457&rft.pages=2449-2457&rft.issn=0009-7322&rft.eissn=1524-4539&rft.coden=CIRCAZ&rft_id=info:doi/10.1161/CIRCULATIONAHA.106.669432&rft_dat=%3Cproquest_pubme%3E68217456%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c412t-50fdf51bb7ea754ad2572b81a4ad4a69dfe72b3d3c2d4618dc96776644d676dc3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=68217456&rft_id=info:pmid/17105848&rfr_iscdi=true |