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Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation: A Systematic Review and Meta-Analysis Outcomes of off- and on-hours admission in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A retrospective observational cohort study Recurrent Cardiovascular Events in Survivors of Myocardial Infarction with St-Segment Elevation (From the AMI-QUEBEC Study) Respiratory syncytial virus infection and risk of acute myocardial infarction Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study Invasive Versus Medical Management in Patients With Prior Coronary Artery Bypass Surgery With a Non-ST Segment Elevation Acute Coronary Syndrome: A Pilot Randomized Controlled Trial Management of ST-segment elevation myocardial infarction in predominantly rural central China: A retrospective observational study SCAI Clinical Expert Consensus Statement on Cardiogenic Shock
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Clinical TrialVolume 39, Issue 29, 1 August 2018, Pages 2730–2739

JOURNAL：Eur Heart J. Article Link

Oxygen therapy in ST-elevation myocardial infarction

R Hofmann, N Witt, B Lagerqvist et al. Keywords: Oxygen；ST-elevation myocardial infarction；Percutaneous coronary intervention； Registry-based randomized clinical trial；Reactive oxygen species；Reperfusion injury

ABSTRACT

AIMS - To determine whether supplemental oxygen in patients with ST-elevation myocardial infarction (STEMI) impacts on procedure-related and clinical outcomes.


METHODS AND RESULTS - The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomized patients with suspected myocardial infarction (MI) to receive oxygen at 6 L/min for 6–12 h or ambient air. In this pre-specified analysis, we included only STEMI patients who underwent percutaneous coronary intervention (PCI). In total, 2807 patients were included, 1361 assigned to receive oxygen, and 1446 assigned to ambient air. The pre-specified primary composite endpoint of all-cause death, rehospitalization with MI, cardiogenic shock, or stent thrombosis at 1 year occurred in 6.3% (86 of 1361) of patients allocated to oxygen compared to 7.5% (108 of 1446) allocated to ambient air [hazard ratio (HR) 0.85, 95% confidence interval (95% CI) 0.64–1.13; P= 0.27]. There was no difference in the rate of death from any cause (HR 0.86, 95% CI 0.61–1.22; P= 0.41), rate of rehospitalization for MI (HR 0.92, 95% CI 0.57–1.48; P= 0.73), rehospitalization for cardiogenic shock (HR 1.05, 95% CI 0.21–5.22; P= 0.95), or stent thrombosis (HR 1.27, 95% CI 0.46–3.51; P= 0.64). The primary composite endpoint was consistent across all subgroups, as well as at different time points, such as during hospital stay, at 30 days and the total duration of follow-up up to 1356 days.


CONCLUSION - Routine use of supplemental oxygen in normoxemic patients with STEMI undergoing primary PCI did not significantly affect 1-year all-cause death, rehospitalization with MI, cardiogenic shock, or stent thrombosis.


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