Oxygen therapy in ST-elevation myocardial infarctionLund Univ, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.
Univ Boras, Dept Hlth Sci, S-50190 Boras, Sweden;Sahlgrens Univ Hosp, Dept Cardiol, S-41345 Gothenburg, Sweden.
Linkoping Univ, Dept Med & Hlth Sci, Sandbacksgatan 7, S-58183 Linkoping, Sweden;Linkoping Univ Hosp, Dept Cardiol, S-58185 Linkoping, Sweden.
Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Cardiol, Morbygardsvagen 5, S-18288 Stockholm, Sweden.
Sahlgrens Univ Hosp, Dept Cardiol, S-41345 Gothenburg, Sweden.
Sahlgrens Univ Hosp, Dept Cardiol, S-41345 Gothenburg, Sweden.
Linkoping Univ, Dept Med & Hlth Sci, Sandbacksgatan 7, S-58183 Linkoping, Sweden;Linkoping Univ Hosp, Dept Cardiol, S-58185 Linkoping, Sweden.
Orebro Univ Hosp, Dept Cardiol, S-70185 Orebro, Sweden.
Lund Univ, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.
Ryhov Hosp, Dept Internal Med, Div Cardiol, Sjukhusgatan, S-55305 Jonkoping, Sweden.
Ryhov Hosp, Dept Internal Med, Div Cardiol, Sjukhusgatan, S-55305 Jonkoping, Sweden.
Karolinska Inst, Karolinska Univ Hosp, Dept Med, S-17176 Solna, Sweden;Karolinska Univ Hosp, Dept Cardiol, S-17176 Stockholm, Sweden.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
Karolinska Inst, Karolinska Univ Hosp, Dept Med, S-17176 Solna, Sweden;Karolinska Inst, Ctr Resuscitat Sci, Soder Sjukhuset, Jagargatan 20, S-11883 Stockholm, Sweden.
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2018 (Engelska)Ingår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, nr 29, s. 2730-2739Artikel i tidskrift (Refereegranskat) Published
Abstract [en]
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.
Conclusions 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.
Ort, förlag, år, upplaga, sidor
OXFORD UNIV PRESS , 2018. Vol. 39, nr 29, s. 2730-2739
Nyckelord [en]
Oxygen, ST-elevation myocardial infarction, Percutaneous coronary intervention, Registry-based randomized clinical trial, Reactive oxygen species, Reperfusion injury
Nationell ämneskategori
Kardiologi
Identifikatorer
URN: urn:nbn:se:uu:diva-363057DOI: 10.1093/eurheartj/ehy326ISI: 000441009100012PubMedID: 29912429OAI: oai:DiVA.org:uu-363057DiVA, id: diva2:1257002
Forskningsfinansiär
Vetenskapsrådet, VR20130307Stiftelsen för strategisk forskning (SSF), SFF KF10-0024Hjärt-Lungfonden2018-10-182018-10-182019-01-21Bibliografiskt granskad