TY - JOUR
T1 - Acute Myocardial Infarction With Hyperoxemic Therapy (AMIHOT). A Prospective, Randomized Trial of Intracoronary Hyperoxemic Reperfusion After Percutaneous Coronary Intervention
AU - O'Neill, William W.
AU - Martin, Jack L.
AU - Dixon, Simon R.
AU - Bartorelli, Antonio L.
AU - Trabattoni, Daniela
AU - Oemrawsingh, Pranobe V.
AU - Atsma, Douwe E.
AU - Chang, Michael
AU - Marquardt, William
AU - Oh, Jae K.
AU - Krucoff, Mitchell W.
AU - Gibbons, Raymond J.
AU - Spears, J. Richard
N1 - Funding Information:
Supported by a grant from TherOx, Inc., Irvine, California. The names of the principal investigators and clinical sites participating in the AMIHOT trial are listed in the Appendix . Presented in part at the Annual Scientific Session of the American College of Cardiology, New Orleans, Louisiana, March 14, 2004.
PY - 2007/7/31
Y1 - 2007/7/31
N2 - Objectives: This study sought to determine whether hyperoxemic reperfusion with aqueous oxygen (AO) improves recovery of ventricular function after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Background: Hyperbaric oxygen reduces myocardial injury and improves ventricular function when administered during ischemia-reperfusion. Methods: In a prospective, multicenter study, 269 patients with acute anterior or large inferior AMI undergoing primary or rescue PCI (<24 h from symptom onset) were randomly assigned after successful PCI to receive hyperoxemic reperfusion (treatment group) or normoxemic blood autoreperfusion (control group). Hyperoxemic reperfusion was performed for 90 min using intracoronary AO. The primary end points were final infarct size at 14 days, ST-segment resolution, and Δ regional wall motion score index of the infarct zone at 3 months. Results: At 30 days, the incidence of major adverse cardiac events was similar between the control and AO groups (5.2% vs. 6.7%, p = 0.62). There was no significant difference in the incidence of the primary end points between the study groups. In post-hoc analysis, anterior AMI patients reperfused <6 h who were treated with AO had a greater improvement in regional wall motion (Δ wall motion score index = 0.54 in control group vs. 0.75 in AO group, p = 0.03), smaller infarct size (23% of left ventricle in control group vs. 9% of left ventricle in AO group, p = 0.04), and improved ST-segment resolution compared with normoxemic controls. Conclusions: Intracoronary hyperoxemic reperfusion was safe and well tolerated after PCI for AMI, but did not improve regional wall motion, ST-segment resolution, or final infarct size. A possible treatment effect was observed in anterior AMI patients reperfused <6 h of symptom onset.
AB - Objectives: This study sought to determine whether hyperoxemic reperfusion with aqueous oxygen (AO) improves recovery of ventricular function after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Background: Hyperbaric oxygen reduces myocardial injury and improves ventricular function when administered during ischemia-reperfusion. Methods: In a prospective, multicenter study, 269 patients with acute anterior or large inferior AMI undergoing primary or rescue PCI (<24 h from symptom onset) were randomly assigned after successful PCI to receive hyperoxemic reperfusion (treatment group) or normoxemic blood autoreperfusion (control group). Hyperoxemic reperfusion was performed for 90 min using intracoronary AO. The primary end points were final infarct size at 14 days, ST-segment resolution, and Δ regional wall motion score index of the infarct zone at 3 months. Results: At 30 days, the incidence of major adverse cardiac events was similar between the control and AO groups (5.2% vs. 6.7%, p = 0.62). There was no significant difference in the incidence of the primary end points between the study groups. In post-hoc analysis, anterior AMI patients reperfused <6 h who were treated with AO had a greater improvement in regional wall motion (Δ wall motion score index = 0.54 in control group vs. 0.75 in AO group, p = 0.03), smaller infarct size (23% of left ventricle in control group vs. 9% of left ventricle in AO group, p = 0.04), and improved ST-segment resolution compared with normoxemic controls. Conclusions: Intracoronary hyperoxemic reperfusion was safe and well tolerated after PCI for AMI, but did not improve regional wall motion, ST-segment resolution, or final infarct size. A possible treatment effect was observed in anterior AMI patients reperfused <6 h of symptom onset.
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U2 - 10.1016/j.jacc.2007.01.099
DO - 10.1016/j.jacc.2007.01.099
M3 - Article
C2 - 17662390
AN - SCOPUS:34447631860
SN - 0735-1097
VL - 50
SP - 397
EP - 405
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 5
ER -