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Incidence and Outcomes of Acute Coronary Syndrome After Transcatheter Aortic Valve Replacement Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Coronary Syndrome Stent Thrombosis Risk Over Time on the Basis of Clinical Presentation and Platelet Reactivity: Analysis From ADAPT-DES Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction Step-by-step manual for planning and performing bifurcation PCI: a resource-tailored approach 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry) Ticagrelor with or without Aspirin in High-Risk Patients after PCI Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial A randomised trial comparing two stent sizing strategies in coronary bifurcation treatment with bioresorbable vascular scaffolds - The Absorb Bifurcation Coronary (ABC) trial
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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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