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Association between Coronary Collaterals and Myocardial Viability in Patients with a Chronic Total Occlusion Effects of clopidogrel vs. prasugrel vs. ticagrelor on endothelial function, inflammatory parameters, and platelet function in patients with acute coronary syndrome undergoing coronary artery stenting: a randomized, blinded, parallel study Acute Coronary Syndrome Following Transcatheter Aortic Valve Replacement Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review Optimal medical therapy vs. coronary revascularization for patients presenting with chronic total occlusion: A meta-analysis of randomized controlled trials and propensity score adjusted studies Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Cardiogenic Shock Switching P2Y12-receptor inhibitors in patients with coronary artery disease

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.