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Whether or not to perform percutaneous coronary intervention (PCI) on sub-acute coronary occlusion in patients late after myocardial infarction

Joao Lucas OConnell, Ana Beatriz F J Carrijo, Marcelo G T dos Anjos, Felipe G Dumont, Monique C M Arajo, Rodrigo Penha Almeida and Leonardo Roever

Despite the almost instinctive tendency of interventional cardiologists to try to reopen important coronary vessels occluded for more than 12 hours post an Acute Myocardial Infarction (AMI), there are several important studies in literature that show no benefit in percutaneous treatment over that of optimized medical therapy regarding general mortality, reinfarction, or heart failure for patients with sub-acute coronary artery occlusion (from more than 12 hours to less than 3 months after an index AMI). The conclusion of prior studies not only demonstrates no benefit, but also the harm that can be caused by this conduct because of its greater tendency towards re-infarction in the group submitted to the intervention (angioplasty with or without stent implantation). Despite this evidence, most interventional cardiologists believe that an attempt at recanalization should be made on patients with a large extent of myocardial viability.