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急性ST段抬高型心肌梗死患者新型冠状动脉内输注过饱和氧疗法:是否有效?

Novel Intracoronary Infusion of Supersaturated Oxygen Therapy in Patients Presenting With Acute ST Elevation Myocardial Infarction: Does It Help?

作者信息

Alamzaib Sardar M, Jensen Jay C, Mansoor Kanaan, Rabbani Noor Ul Ann, Sayyed Rameez

机构信息

Cardiology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2023 Jun 3;15(6):e39915. doi: 10.7759/cureus.39915. eCollection 2023 Jun.

Abstract

Supersaturated oxygen (SSO) is one of the emerging therapies that has shown benefit for patients suffering from acute ST elevation myocardial infarction (STEMI) in terms of reducing infarct size, which has been used as a prognostic indicator for future heart failure and hospitalizations. Trials investigating SSO therapy have shown improvement in infarct size when used as an adjunct therapy to percutaneous trans-luminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (aMI).  Here we present a patient with a mid left anterior descending artery (mLAD) STEMI who underwent SSO therapy. The patient presented with new onset angina and ST elevations on EKG. He underwent emergent coronary angiography, which confirmed an mLAD complete vessel occlusion. Successful PCI was done with a drug-eluting stent followed by supersaturated oxygen therapy. On follow-up evaluation, the patient had improved left ventricular (LV) ejection fraction from 35% to 60%. This case highlights the safety and efficacy of SSO therapy for patients suffering from acute anterior wall myocardial infarction. We recommend further investigation of this therapy for its routine use, safety, and prognostic utility. We also recommend routine use of adjunctive SSO therapy for patients suffering acute anterior STEMI.

摘要

超饱和氧(SSO)是一种新兴疗法,已显示对急性ST段抬高型心肌梗死(STEMI)患者有益,可减小梗死面积,而梗死面积已被用作未来心力衰竭和住院治疗的预后指标。研究SSO疗法的试验表明,在急性心肌梗死(aMI)患者中,将其用作经皮腔内冠状动脉成形术(PTCA)或经皮冠状动脉介入治疗(PCI)的辅助疗法时,梗死面积有所改善。在此,我们介绍一位患有左前降支中段(mLAD)STEMI并接受SSO治疗的患者。该患者出现新发心绞痛,心电图显示ST段抬高。他接受了急诊冠状动脉造影,证实mLAD完全血管闭塞。成功植入药物洗脱支架后进行了超饱和氧治疗。随访评估显示,患者左心室(LV)射血分数从35%提高到了60%。该病例突出了SSO疗法对急性前壁心肌梗死患者的安全性和有效性。我们建议对该疗法的常规使用、安全性和预后效用进行进一步研究。我们还建议对急性前壁STEMI患者常规使用辅助性SSO疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7fd/10239294/0118f4ef0d8a/cureus-0015-00000039915-i01.jpg

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