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Imaging Coronary Anatomy and Reducing Myocardial Infarction Oxygen therapy in ST-elevation myocardial infarction Ticagrelor or Prasugrel in Patients with ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention A randomised trial comparing two stent sizing strategies in coronary bifurcation treatment with bioresorbable vascular scaffolds - The Absorb Bifurcation Coronary (ABC) trial Proportion and Morphological Features of Restenosis Lesions With Acute Coronary Syndrome in Different Timings of Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation Complete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial Effect of Smoking on Outcomes of Primary PCI in Patients With STEMI Inflammatory Bowel Disease and Acute Coronary Syndromes: From Pathogenesis to the Fine Line Between Bleeding and Ischemic Risk Predicting Major Adverse Events in Patients With Acute Myocardial Infarction

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.