OBJECTIVE: Recent studies suggest that administration of O2 in patients with acute myocardial infarction may have negative effects. With the use of cardiac MRI (CMR), we evaluated the effects of supplemental O2 in patients with ST elevation myocardial infarction (STEMI) accepted for acute percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This study was a randomized-controlled trial conducted at two university hospitals in Sweden. Normoxic STEMI patients were randomized in the ambulance to either supplemental O2 (10 l/min) or room air until the conclusion of the PCI. CMR was performed 2-6 days after the inclusion. The primary endpoint was the myocardial salvage index assessed by CMR. The secondary endpoints included infarct size and myocardium at risk. RESULTS: At inclusion, the O2 (n=46) and air (n=49) patient groups had similar patient characteristics. There were no significant differences in myocardial salvage index [53.9±25.1 vs. 49.3±24.0%; 95% confidence interval (CI): -5.4 to 14.6], myocardium at risk (31.9±10.0% of the left ventricle in the O2 group vs. 30.0±11.8% in the air group; 95% CI: -2.6 to 6.3), or infarct size (15.6±10.4% of the left ventricle vs. 16.0±11.0%; 95% CI: -4.7 to 4.1). CONCLUSION: In STEMI patients undergoing acute PCI, we found no effect of high-flow oxygen compared with room air on the size of ischemia before PCI, myocardial salvage, or the resulting infarct size. These results support the safety of withholding supplemental oxygen in normoxic STEMI patients.
RCT Entities:
OBJECTIVE: Recent studies suggest that administration of O2 in patients with acute myocardial infarction may have negative effects. With the use of cardiac MRI (CMR), we evaluated the effects of supplemental O2 in patients with ST elevation myocardial infarction (STEMI) accepted for acute percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This study was a randomized-controlled trial conducted at two university hospitals in Sweden. Normoxic STEMI patients were randomized in the ambulance to either supplemental O2 (10 l/min) or room air until the conclusion of the PCI. CMR was performed 2-6 days after the inclusion. The primary endpoint was the myocardial salvage index assessed by CMR. The secondary endpoints included infarct size and myocardium at risk. RESULTS: At inclusion, the O2 (n=46) and air (n=49) patient groups had similar patient characteristics. There were no significant differences in myocardial salvage index [53.9±25.1 vs. 49.3±24.0%; 95% confidence interval (CI): -5.4 to 14.6], myocardium at risk (31.9±10.0% of the left ventricle in the O2 group vs. 30.0±11.8% in the air group; 95% CI: -2.6 to 6.3), or infarct size (15.6±10.4% of the left ventricle vs. 16.0±11.0%; 95% CI: -4.7 to 4.1). CONCLUSION: In STEMI patients undergoing acute PCI, we found no effect of high-flow oxygen compared with room air on the size of ischemia before PCI, myocardial salvage, or the resulting infarct size. These results support the safety of withholding supplemental oxygen in normoxic STEMI patients.
Authors: Jakob Almer; Viktor Elmberg; Josef Bränsvik; David Nordlund; Ardavan Khoshnood; Michael Ringborn; Marcus Carlsson; Ulf Ekelund; Henrik Engblom Journal: Ann Noninvasive Electrocardiol Date: 2018-09-28 Impact factor: 1.468
Authors: Alexander Thomas; Sean van Diepen; Rachel Beekman; Shashank S Sinha; Samuel B Brusca; Carlos L Alviar; Jacob Jentzer; Erin A Bohula; Jason N Katz; Andi Shahu; Christopher Barnett; David A Morrow; Emily J Gilmore; Michael A Solomon; P Elliott Miller Journal: JACC Adv Date: 2022-08-26
Authors: Marija Barbateskovic; Olav L Schjørring; Sara Russo Krauss; Janus C Jakobsen; Christian S Meyhoff; Rikke M Dahl; Bodil S Rasmussen; Anders Perner; Jørn Wetterslev Journal: Cochrane Database Syst Rev Date: 2019-11-27
Authors: David Nordlund; Henrik Engblom; Jean-Louis Bonnet; Henrik Steen Hansen; Dan Atar; David Erlinge; Ulf Ekelund; Einar Heiberg; Marcus Carlsson; Håkan Arheden Journal: BMC Cardiovasc Disord Date: 2019-07-03 Impact factor: 2.298
Authors: Yue Yu; Jun Wang; Qing Wang; Junnan Wang; Jie Min; Suyu Wang; Pei Wang; Renhong Huang; Jian Xiao; Yufeng Zhang; Zhinong Wang Journal: Ann Transl Med Date: 2020-11