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Editorial
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This editorial highlights that large randomized clinical trials can sometimes yield unexpected results that contradict logical hypotheses or smaller trials, referencing a study on collateral flow in recent myocardial infarction.
T ime 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.
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Kanu Chatterjee (2010) studied this question.
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