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Three-Year Outcomes of the DKCRUSH-V Trial Comparing DK Crush With Provisional Stenting for Left Main Bifurcation Lesions Percutaneous Coronary Intervention Techniques for Bifurcation Disease: Network Meta-analysis Reveals Superiority of Double-Kissing Crush Randomized Comparison of FFR-Guided and Angiography-Guided Provisional Stenting of True Coronary Bifurcation Lesions: The DKCRUSH-VI Trial (Double Kissing Crush Versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions VI) Optical coherence tomography predictors of target vessel myocardial infarction after provisional stenting in patients with coronary bifurcation disease PCI for obstructive bifurcation lesions the 14th consensus document from the european bifurcation club Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction With Nonobstructive Coronary Arteries in Women Double-Kissing Culotte Technique for Coronary Bifurcation Stenting - Technical evaluation and comparison with conventional double stenting techniques Clinical Outcomes Following Coronary Bifurcation PCI Techniques: A Systematic Review and Network Meta-Analysis Comprising 5,711 Patients Randomized study of the crush technique versus provisional side-branch stenting in true coronary bifurcations: the CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) Study Treatment of calcified coronary lesions with Palmaz-Schatz stents. An intravascular ultrasound study
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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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