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Oxygen Therapy in Suspected Acute Myocardial Infarction
Södersjukhuset, Sweden.
Uppsala University, Sweden.
Danderyd Hospital, Sweden.
Uppsala University, Sweden.
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2017 (English)In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 377, no 13, 1240-1249 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction who do not have hypoxemia at baseline is uncertain. 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. 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. 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.

Place, publisher, year, edition, pages
MASSACHUSETTS MEDICAL SOC , 2017. Vol. 377, no 13, 1240-1249 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-141929DOI: 10.1056/NEJMoa1706222ISI: 000411838100007PubMedID: 28844200OAI: oai:DiVA.org:liu-141929DiVA: diva2:1149194
Note

Funding Agencies|Swedish Heart-Lung Foundation; Swedish Research Council; Swedish Foundation for Strategic Research; AstraZeneca; Merck Sharp Dohme; Aspen; Roche; BioMerieux; Philips; Thermofisher; the Medicines Company

Available from: 2017-10-13 Created: 2017-10-13 Last updated: 2017-10-31

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The full text will be freely available from 2018-03-28 15:45
Available from 2018-03-28 15:45

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Alfredsson, JoakimNilsson, Lennart
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
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New England Journal of Medicine
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