Judith Hochman and colleagues’ study, published in New England Journal of Medicine, expected to alter the use of angioplasty

In a study conceived nearly a decade ago and evaluating the results of “late angioplasty” in over 2000 patients at 217 hospitals in the U.S. and abroad, Dr. Judith Hochman and colleagues conclude the procedure does not help stable patients with persistent total occlusion of the infarct artery whose heart attacks occurred three to 28 days earlier.

According to the New York Times on Nov. 15, “Dr. Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute, which helped pay for the research, said: ‘This is an important study. It’s definitive. The evidence from it should be weighed very carefully by the groups that formulate guidelines about when to conduct angioplasty in the setting of a heart attack.’ ”

The New England Journal of Medicine released the study three weeks early, on Nov. 14, for web posting simultaneous with Dr. Hochman's presentation of her findings at the annual scientific session of the American Heart Association in Chicago.

In its front-page article, the Times cites “an expert not involved in the research, Dr. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic and president of the American College of Cardiology,” saying “the study was independent and well-conducted.

" ‘Having an artery open ought to be good for you,’ he said. ‘Why not open it late? Like a lot of things in medicine, however, when you actually test it in an organized way, in a randomized, controlled trial, you find out it doesn't work.’ "

[Text of study published in the New England Journal of Medicine]