The VERDICT Trial

This study is unable to comment on whether patients with STEMI(-) Occlusion MI have benefit from emergent cath, because that is not the population studied and this subgroup is not commented on.This study is just the most recent in a long long line of similar literature. Context is everything for understanding this study. See below for an excerpt from theOMI Manifesto which summarizes the existing literature and provides details on each study:-------------------------------------------------------------------------------------------------------------- Counter-argument:“Haven’t there been RCTs showing no benefit for early vs. delayed intervention for NSTEMI patients? If so, why didn’t the subtle ACOs in these NSTEMI cohorts generate a benefit for the early intervention groups?”There is a moderately-sized body of literature which has been mistakenly used to claim that there is no difference in outcomes between immediate vs. urgent invasive treatment for NSTEMI, explained in detail below. Even if this were an accurate representation of the literature, it would not disprove the theory that the subgroup of NSTEMI patients with ACO benefit from emergent invasive management. If the percentage of patients with ACO is low in the study population of NSTEMIs, even a large mortality benefit (for those with ACO) will not be observable in a small RCT. If you randomize five patients with ACO as well as 300 without ACO, you may not detect a difference in outcomes even if all five ACO ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs