Occluded Artery Trial (OAT)

Exclusion Criteria

• •Age \<18 y
• •Clinical indication for revascularization defined as follows: rest or low-threshold angina after MI; severe inducible ischemia on low level exercise or pharmacological stress testing (ST decreased ≥2 mm or inability to complete stage 1 or achieve 3-4 metabolic equivalents without angina, hypotension, or reversible perfusion defects in multiple territories or decreased wall motion thickening in \>2 segments on echocardiogram); left main coronary disease (≥50% stenosis); or triple-vessel disease (3 major epicardial coronaries with \>70% stenoses)
• •Serious illness such as cancer or pulmonary disease that limits 3-year survival
• •Severe renal disease defined as serum creatinine \>3.0 mg/dL that markedly increases risk of radiographic contrast
• •Severe valvular disease
• •History of anaphylaxis to radiographic contrast
• •Infarct artery too small (reference segment diameter \<2.5 mm), target segment within or beyond extreme tortuosity (\>90° angulation), or otherwise technically a poor candidate for PCI
• •Chronic occlusion of IRA (seen on angiogram obtained before index MI or angiographic evidence of chronicity, e.g., presence of bridging collaterals)
• •NYHA classes III-IV CHF; patients may be treated for acute heart failure complicating MI and rescreened
• •Cardiogenic shock or sustained hypotension: systolic BP \<90 mm Hg or cardiac index \<2.2 L/min per m\^2
• •LV aneurysm in the same location as index MI and present before index MI
• •Inability to cooperate with the protocol
• •Patient refusal or inability to give informed consent
• •Refusal of patient's physician to allow patient to participate
• •Pregnancy
• •Contraindication to anticoagulation during PCI or to routine antiplatelet therapy after stent implantation
• •Qualifying IRA that has been grafted previously; patients with prior CABG may be enrolled if the IRA was not previously grafted
• •Dilated or hypertrophic cardiomyopathy