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Oxygen Therapy in Suspected Acute Myocardial Infarction.
- Source :
-
The New England journal of medicine [N Engl J Med] 2017 Sep 28; Vol. 377 (13), pp. 1240-1249. Date of Electronic Publication: 2017 Aug 28. - Publication Year :
- 2017
-
Abstract
- Background: The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction who do not have hypoxemia at baseline is uncertain.<br />Methods: In this registry-based randomized clinical trial, we used nationwide Swedish registries for patient enrollment and data collection. Patients with suspected myocardial infarction and an oxygen saturation of 90% or higher were randomly assigned to receive either supplemental oxygen (6 liters per minute for 6 to 12 hours, delivered through an open face mask) or ambient air.<br />Results: A total of 6629 patients were enrolled. The median duration of oxygen therapy was 11.6 hours, and the median oxygen saturation at the end of the treatment period was 99% among patients assigned to oxygen and 97% among patients assigned to ambient air. Hypoxemia developed in 62 patients (1.9%) in the oxygen group, as compared with 254 patients (7.7%) in the ambient-air group. The median of the highest troponin level during hospitalization was 946.5 ng per liter in the oxygen group and 983.0 ng per liter in the ambient-air group. The primary end point of death from any cause within 1 year after randomization occurred in 5.0% of patients (166 of 3311) assigned to oxygen and in 5.1% of patients (168 of 3318) assigned to ambient air (hazard ratio, 0.97; 95% confidence interval [CI], 0.79 to 1.21; P=0.80). Rehospitalization with myocardial infarction within 1 year occurred in 126 patients (3.8%) assigned to oxygen and in 111 patients (3.3%) assigned to ambient air (hazard ratio, 1.13; 95% CI, 0.88 to 1.46; P=0.33). The results were consistent across all predefined subgroups.<br />Conclusions: Routine use of supplemental oxygen in patients with suspected myocardial infarction who did not have hypoxemia was not found to reduce 1-year all-cause mortality. (Funded by the Swedish Heart-Lung Foundation and others; DETO2X-AMI ClinicalTrials.gov number, NCT01787110 .).
- Subjects :
- Aged
Female
Follow-Up Studies
Heart Diseases diagnosis
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction diagnosis
Myocardial Infarction mortality
Proportional Hazards Models
Registries
Sweden
Treatment Failure
Myocardial Infarction therapy
Oxygen Inhalation Therapy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1533-4406
- Volume :
- 377
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- The New England journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28844200
- Full Text :
- https://doi.org/10.1056/NEJMoa1706222