English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Time and time again, randomized clinical trials have demonstrated that what is conceptually logical and should be right is not always right. Randomized large clinical trials are often undertaken on the basis of this logical hypothesis. Very often, small clinical trials also show encouraging results.1,2 However, when large randomized clinical trials are performed, they not infrequently reveal rather disappointing and unexpected results. The study by Steg et al, “Impact of Collateral Flow to the Occluded Infarct-Related Artery on Clinical Outcomes in Patients with Recent Myocardial Infarction: A Report From the Randomized Occluded Artery Trial,” reported in this issue of Circulation , proves this again.3Article see p 2724 The investigators of the Occluded Artery Trial (OAT) studied the influence of presence or absence of collateral blood flow to the territory of the infarct-related artery on long-term clinical outcomes including death, reinfarction, and reverse remodeling and the development of Stage C heart failure. The effect of recanalization of the occluded artery by percutaneous coronary intervention (PCI) and medical therapy was also compared to that of medical therapy alone.The OAT study enrolled 2201 patients; 1087 and 1086 patients were randomized, respectively, to PCI and medical therapy and to medical therapy alone. The collateral blood flow was estimated semiquantitatively on the basis of accepted angiographic criteria. The degree of collateral blood flow was then correlated to the long-term outcome including death, reinfarction, and class III or IV heart failure. The impact on ventricular reverse remodeling was not assessed.The results of this study demonstrate that the absence of collateral blood flow is associated with worse prognosis in relation to death and systolic heart failure. Furthermore, the study also reports that the higher the extent of collateral blood flow, the lower the rate of death and severe heart failure; but no …

Collateral Flow to the Territory of the Occluded Infarct-Related Artery