Ivan D Hanson1, Shukri W David2, Simon R Dixon1, D Christopher Metzger3, Philippe Généreux4,5,6, Akiko Maehara5,6, Ke Xu6, Gregg W Stone5,6. 1. Beaumont Health System, Royal Oak, Michigan. 2. Providence Hospital, Southfield, Michigan. 3. Wellmont Holston Valley Medical Center, Kingsport, Tennessee. 4. Hôpital Du Sacré-Coeur De Montréal, Montréal, Québec, Canada. 5. Columbia University Medical Center, New York, New York. 6. Cardiovascular Research Foundation, New York, New York.
Abstract
OBJECTIVES: We sought to evaluate the feasibility and safety of catheter-based supersaturated oxygen (SSO2 ) delivery via the left main coronary artery (LMCA) following primary percutaneous coronary intervention (PCI). BACKGROUND: In the multicenter, randomized AMIHOT-II trial, SSO2 delivered into the proximal or mid left anterior descending (LAD) artery via an indwelling intracoronary infusion catheter in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) following primary PCI significantly reduced infarct size but resulted in a numerically higher incidence of safety events. METHODS:Patients with acute anterior STEMI presenting within 6 hr of symptom onset were enrolled at three centers. Following successful LAD stenting, SSO2 was infused into the LMCA via a diagnostic catheter for 60 min. The primary safety endpoint was the 30-day rate of target vessel failure (composite of death, reinfarction, or target vessel revascularization). Cardiac magnetic resonance imaging (cMRI) was performed at 3-5 and 30 days to assess infarct size. RESULTS:Twenty patients with acute anterior STEMI were enrolled. The infarct lesion was located in the proximal LAD in 7 cases (35%) and the mid LAD in 13 cases (65%). Following primary PCI, SSO2 was delivered successfully in all cases. Target vessel failure within 30 days occurred in 1 patient (5%). Median [interquartile range] infarct size was 13.7% [5.4-20.6%] at 3-5 days and 9.6% [2.1-14.5%] at 30 days. CONCLUSIONS: Following primary PCI in acute anterior STEMI, infusion of SSO2 via the LMCA is feasible, and is associated with a favorable early safety and efficacy profile.
RCT Entities:
OBJECTIVES: We sought to evaluate the feasibility and safety of catheter-based supersaturated oxygen (SSO2 ) delivery via the left main coronary artery (LMCA) following primary percutaneous coronary intervention (PCI). BACKGROUND: In the multicenter, randomized AMIHOT-II trial, SSO2 delivered into the proximal or mid left anterior descending (LAD) artery via an indwelling intracoronary infusion catheter in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) following primary PCI significantly reduced infarct size but resulted in a numerically higher incidence of safety events. METHODS:Patients with acute anterior STEMI presenting within 6 hr of symptom onset were enrolled at three centers. Following successful LAD stenting, SSO2 was infused into the LMCA via a diagnostic catheter for 60 min. The primary safety endpoint was the 30-day rate of target vessel failure (composite of death, reinfarction, or target vessel revascularization). Cardiac magnetic resonance imaging (cMRI) was performed at 3-5 and 30 days to assess infarct size. RESULTS: Twenty patients with acute anterior STEMI were enrolled. The infarct lesion was located in the proximal LAD in 7 cases (35%) and the mid LAD in 13 cases (65%). Following primary PCI, SSO2 was delivered successfully in all cases. Target vessel failure within 30 days occurred in 1 patient (5%). Median [interquartile range] infarct size was 13.7% [5.4-20.6%] at 3-5 days and 9.6% [2.1-14.5%] at 30 days. CONCLUSIONS: Following primary PCI in acute anterior STEMI, infusion of SSO2 via the LMCA is feasible, and is associated with a favorable early safety and efficacy profile.
Authors: Robert A Kloner; Jeffrey L Creech; Gregg W Stone; William W O'Neill; Daniel Burkhoff; J Richard Spears Journal: JACC Basic Transl Sci Date: 2021-10-27
Authors: Grzegorz L Kaluza; Jeffrey L Creech; Ariel Furer; Maxwell E Afari; Krzysztof Milewski; Geng-Hua Yi; Yanping Cheng; Gerard B Conditt; Jenn C McGregor; Donald Blum; Serge D Rousselle; Juan F Granada; Daniel Burkhoff Journal: Sci Rep Date: 2022-04-06 Impact factor: 4.379