Clinical Trials Center, Cardiovascular Research Foundation, New York.
Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York.
Catheter Cardiovasc Interv. 2021 May 1;97(6):1120-1126. doi: 10.1002/ccd.29090. Epub 2020 Jul 10.
Supersaturated oxygen (SSO ) has recently been approved by the U.S. Food and Drug Administration for administration after primary percutaneous coronary intervention (pPCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI) based on its demonstration of infarct size reduction in the IC-HOT study.
To describe the 1-year clinical outcomes of intracoronary SSO treatment after pPCI in patients with anterior STEMI.
IC-HOT was a prospective, open-label, single-arm study in which 100 patients without cardiogenic shock undergoing successful pPCI of an occluded left anterior descending coronary artery were treated with a 60-min SSO infusion. One-year clinical outcomes were compared with a propensity-matched control group of similar patients with anterior STEMI enrolled in the INFUSE-AMI trial.
Baseline and postprocedural characteristics were similar in the two groups except for pre-PCI thrombolysis in myocardial infarction 3 flow, which was less prevalent in patients treated with SSO (9.6% vs. 22.9%, p = .02). Treatment with SSO was associated with a lower 1-year rate of the composite endpoint of all-cause death or new-onset heart failure (HF) or hospitalization for HF (0.0% vs. 12.3%, p = .001). All-cause mortality, driven by cardiovascular mortality, and new-onset HF or HF hospitalization were each individually lower in SSO -treated patients. There were no significant differences between groups in the 1-year rates of reinfarction or clinically driven target vessel revascularization.
Infusion of SSO following pPCI in patients with anterior STEMI was associated with improved 1-year clinical outcomes including lower rates of death and new-onset HF or HF hospitalizations.
基于 IC-HOT 研究显示可缩小梗死面积，美国食品和药物管理局最近批准在接受经皮冠状动脉介入治疗（pPCI）的前壁 ST 段抬高型心肌梗死（STEMI）患者中应用过饱和氧（SSO）。
描述 pPCI 后前壁 STEMI 患者接受冠状动脉内 SSO 治疗的 1 年临床结局。
IC-HOT 是一项前瞻性、开放标签、单臂研究，纳入 100 例未发生心原性休克且成功接受闭塞前降支 pPCI 的患者，接受 60 分钟 SSO 输注。与接受 INFUSE-AMI 试验的类似前壁 STEMI 患者的倾向评分匹配对照组相比，比较了 1 年临床结局。
两组患者的基线和术后特征相似，除了 SSO 治疗组患者的 PCI 前心肌梗死溶栓治疗 3 级血流较少（9.6% vs. 22.9%，p=0.02）。与 SSO 治疗相关的 1 年复合终点（全因死亡或新发心力衰竭[HF]或 HF 住院）发生率较低（0.0% vs. 12.3%，p=0.001）。心血管死亡率导致的全因死亡率和新发 HF 或 HF 住院率在 SSO 治疗患者中均较低。两组间 1 年再梗死或临床驱动的靶血管血运重建率无显著差异。
在前壁 STEMI 患者接受 pPCI 后应用 SSO 可改善 1 年临床结局，包括降低死亡率和新发 HF 或 HF 住院率。
