Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials

Sepehrvand, Nariman; James, Stefan; Khoshnood, Ardavan; Hofmann, Robin

doi:10.1136/heartjnl-2018-313089

Cited by 39 publications

(38 citation statements)

References 37 publications

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“…When focusing on patients with ST-elevation MI, they found a similar result (9). Two meta-analyses of oxygen therapy in patients with acute MI reached the same conclusions, which were that oxygen therapy was not associated with important clinical outcomes in normoxemic patients (10,11). Greater cardiac injury did not lead to more death in patients with acute MI.…”

Section: Discussionmentioning

confidence: 75%

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Yang¹,

Shang²,

Yuan³

2019

J. Thorac. Dis.

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Background: Data on the safety and feasibility of pulse oxygen saturation (SpO 2 ) directed oxygen therapy in mainland China are scarce. The aim of this pilot study was to test the feasibility of SpO time to death within 28 days between the two groups was not different (P=0.284). Conclusions: SpO 2 directed oxygen therapy in critically ill patients was feasible. Our pilot trial necessitates and rationalizes our large-sample multicenter trial.

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Section: Discussionmentioning

confidence: 75%

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Yang¹,

Shang²,

Yuan³

2019

J. Thorac. Dis.

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“…However, thrombolytic therapy or coronary intervention can trigger myocardial ischemia reperfusion [2,3]. Myocardial ischemia reperfusion can further aggravate the original myocardial injury, and this pathological process is clinically known as myocardial ischemia reperfusion injury (MIRI) [4]. Current studies have shown that the case mechanism of MIRI is very complex, which is closely related to increased myocardial oxidative stress after MIRI, myocardial apoptosis caused by Ca overload, or decreased stability of mitochondrial membrane, autophagy, myocardial inflammation, and energy metabolism disorder [5,6].…”

Section: Introductionmentioning

confidence: 99%

Paeoniflorin on Rat Myocardial Ischemia Reperfusion Injury of Protection and Mechanism Research

et al. 2019

Pharmacology

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Objective: To study the myocardial benefit effect and mechanism of paeoniflorin on myocardial ischemia reperfusion injury (MIRI) in rats. Methods: Hundred SD rats were randomly divided into 5 groups: sham group, model group, Paeoniflorin (15 mg/kg) group, Paeoniflorin (30 mg/kg) group, and Paeoniflorin (60 mg/kg) group. Myocardial ischemia reperfusion model was established in each group except the sham group. The myocardial infarction and morphological changes were measured by the TTC staining and HE staining respectively. Myocardial caspase-3 was detected by immunohistochemistry. In addition, the protein levels of Bcl-2 and Bax and the expression ratio of p-erk, p-jnk, and p-p38 were detected by Western blot. Myocardial superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were measured by the assay kit. Results: Paeoniflorin (30 mg/kg) and Paeoniflorin (60 mg/kg) can obviously alleviate myocardial infarction caused by MIRI (p < 0.05). HE staining showed that the myocardial morphology in the treatment group was obviously better than that in the model group. WB and immunohistochemistry showed that Paeoniflorin (30 mg/kg) andPaeoniflorin (60 mg/kg) can significantly increase the reduced protein level of bcl-2 (p < 0.05) and reduce the increased protein level of caspase3, bax p-erk, p-jnk, and p-p38 caused by MIRI (p < 0.05). The activity of SOD was increased and the level of MDA was decreased after Paeoniflorin treatment. Conclusion: Paeoniflorin preconditioning has a protective effect on MIRI in rats. Its mechanism is related to reducing oxidative stress and apoptosis by inhibiting the expression of apoptosis-related signaling pathway.

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“…These findings were confirmed in a recent metaanalysis including eight RCTs studying the effects of supplemental O 2 therapy in patients with suspected and confirmed MI (n = 7998), showing no clinical benefits [45]. In another meta-analysis including 25 RCTs and a total study population of 16,037 acutely ill patients, it was shown that supplemental O 2 therapy in normoxemic (blood O 2 saturation ≥ 94%) patients increased mortality [46].…”

Section: Discussionmentioning

confidence: 76%

Oxygen therapy in patients with ST elevation myocardial infarction based on the culprit vessel: results from the randomized controlled SOCCER trial

et al. 2020

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Background: Oxygen (O 2 ) treatment has been a cornerstone in the treatment of patients with myocardial infarction. Recent studies, however, state that supplemental O 2 therapy may have no effect or harmful effects in these patients. The aim of this study was thus to evaluate the effect of O 2 therapy in patients with ST Elevation Myocardial Infarction (STEMI) based on the culprit vessel; Left Anterior Descending Artery (LAD) or Non-LAD. Methods: 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 2 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). Results: 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. Conclusion:The results indicate that the location of the culprit vessel has probably no effect on the role of supplemental oxygen therapy in STEMI patients. Trial registration: Swedish Medical Products Agency (EudraCT No. 2011-001452-11) and ClinicalTrials.gov Identifier (NCT01423929).

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Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials

Abstract: Although supplemental O therapy is commonly used, it was not associated with important clinical benefits. These findings from eight RCTs support departing from the usual practice of administering oxygen in normoxaemic patients.

Cited by 39 publications

References 37 publications

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study

Paeoniflorin on Rat Myocardial Ischemia Reperfusion Injury of Protection and Mechanism Research

Oxygen therapy in patients with ST elevation myocardial infarction based on the culprit vessel: results from the randomized controlled SOCCER trial

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