Department of Clinical Sciences Lund, Cardiology, Lund University, Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences Lund, Emergency and Internal Medicine, Lund University, Skåne University Hospital, Akutmottagningen, EA10, SUS Lund, 221 85, Lund, Sweden.
BMC Emerg Med. 2020 Feb 18;20(1):12. doi: 10.1186/s12873-020-00309-y.
Oxygen (O) treatment has been a cornerstone in the treatment of patients with myocardial infarction. Recent studies, however, state that supplemental O therapy may have no effect or harmful effects in these patients. The aim of this study was thus to evaluate the effect of O therapy in patients with ST Elevation Myocardial Infarction (STEMI) based on the culprit vessel; Left Anterior Descending Artery (LAD) or Non-LAD.
This was a two-center, investigator-initiated, single-blind, parallel-group, randomized controlled trial at the Skåne university hospital, Sweden. A simple computer-generated randomization was used. Patients were either randomized to standard care with O therapy (10 l/min) or air until the end of the primary percutaneous coronary intervention. The patients underwent a Cardiac Magnetic Resonance Imaging (CMRI) days 2-6. The main outcome measures were Myocardium at Risk (MaR), Infarct Size (IS) and Myocardial Salvage Index (MSI) as measured by CMRI, and median high-sensitive troponin T (hs-cTnT).
A total of 229 patients were assessed for eligibility, and 160 of them were randomized to the oxygen or air arm. Because of primarily technical problems with the CMRI, 95 patients were included in the final analyses; 46 in the oxygen arm and 49 in the air arm. There were no significant differences between patients with LAD and Non-LAD as culprit vessel with regard to their allocation (oxygen or air) with regards to MSI, MaR, IS and hs-cTnT.
The results indicate that the location of the culprit vessel has probably no effect on the role of supplemental oxygen therapy in STEMI patients.
Swedish Medical Products Agency (EudraCT No. 2011-001452-11) and ClinicalTrials.gov Identifier (NCT01423929).
氧气 (O) 治疗一直是治疗心肌梗死患者的基石。然而，最近的研究表明，补充 O 治疗可能对这些患者没有效果或有害影响。因此，本研究旨在根据罪犯血管（左前降支或非左前降支）评估 O 治疗对 ST 段抬高型心肌梗死 (STEMI) 患者的疗效。
这是在瑞典斯科讷大学医院进行的一项两中心、研究者发起的、单盲、平行组、随机对照试验。采用简单的计算机生成随机化。患者随机分为接受 O 治疗（10L/min）或空气治疗直至经皮冠状动脉介入治疗结束的标准治疗组。患者在第 2-6 天行心脏磁共振成像 (CMRI)。主要结局指标为 CMRI 测量的心肌危险区 (MaR)、梗死面积 (IS) 和心肌挽救指数 (MSI)，以及中位数高敏肌钙蛋白 T (hs-cTnT)。
共有 229 名患者进行了资格评估，其中 160 名患者被随机分配到 O 或空气组。由于 CMRI 主要存在技术问题，最终有 95 名患者纳入了最终分析；46 名在 O 组，49 名在空气组。在罪犯血管为左前降支和非左前降支的患者中，关于他们的分配（O 或空气），在 MSI、MaR、IS 和 hs-cTnT 方面没有显著差异。
结果表明，罪犯血管的位置可能对 STEMI 患者补充 O 治疗的作用没有影响。
瑞典药品管理局（EudraCT No. 2011-001452-11）和 ClinicalTrials.gov 标识符（NCT01423929）。
