The benefits of routine, ie, non ischemia-driven, PCI of an angiographically significant stenosis in a patent infarct artery >24 hours after STEMI are less well established.232,233,378 Delayed PCI of a totally occluded infarct artery >24 hours after STEMI should not be undertaken in clinically stable patients without evidence of severe ischemia. In OAT (Occluded Artery Trial), there was no difference in the composite end- point of death, reinfarction, or class IV HF at a median follow- up of 5.8 years between patients managed with PCI and those treated medically. Reinfarction rates tended to be higher in the 6.3. PCI of a Noninfarct Artery Before Hospital Discharge: Recommendations Class I 1. PCI is indicated in a noninfarct artery at a time sepa- rate from primary PCI in patients who have spon- taneous symptoms of myocardial ischemia. (Level of Evidence: C) Class IIa 1. PCI is reasonable in a noninfarct artery at a time separate from primary PCI in patients with inter- mediate- or high-risk findings on noninvasive test- (Level of Evidence: B) Multivessel coronary artery disease is present in 40% to 65% of patients presenting with STEMI who undergo primary PCI and is associated with adverse prognosis.381,382 Studies of staged PCI of noninfarct arteries have been nonrandomized in design and have varied with regard to the timing of PCI and duration of follow-up. 