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Supplemental oxygen therapy does not affect the systemic inflammatory response to acute myocardial infarction
Authors:R. Hofmann  P. Tornvall  N. Witt  J. Alfredsson  L. Svensson  L. Jonasson  L. Nilsson
Affiliation:1. Department of Clinical Science and Education, Division of Cardiology, Karolinska Institutet, S?dersjukhuset, Stockholm, Sweden;2. Department of Cardiology, Department of Medical and Health Sciences, Link?ping University, Link?ping, Sweden;3. Department of Medicine, Solna and Centre for Resuscitation Science, Karolinska Institutet, S?dersjukhuset, Stockholm, Sweden
Abstract:

Background

Oxygen therapy has been used routinely in normoxemic patients with suspected acute myocardial infarction (AMI ) despite limited evidence supporting a beneficial effect. AMI is associated with a systemic inflammation. Here, we hypothesized that the inflammatory response to AMI is potentiated by oxygen therapy.

Methods

The DET ermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO 2X‐AMI ) multicentre trial randomized patients with suspected AMI to receive oxygen at 6 L min?1 for 6–12 h or ambient air. For this prespecified subgroup analysis, we recruited patients with confirmed AMI from two sites for evaluation of inflammatory biomarkers at randomization and 5–7 h later. Ninety‐two inflammatory biomarkers were analysed using proximity extension assay technology, to evaluate the effect of oxygen on the systemic inflammatory response to AMI .

Results

Plasma from 144 AMI patients was analysed whereof 76 (53%) were randomized to oxygen and 68 (47%) to air. Eight biomarkers showed a significant increase, whereas 13 were decreased 5–7 h after randomization. The inflammatory response did not differ between the two treatment groups neither did plasma troponin T levels. After adjustment for increase in troponin T over time, age and sex, the release of inflammation‐related biomarkers was still similar in the groups.

Conclusions

In a randomized controlled setting of normoxemic patients with AMI , the use of supplemental oxygen did not have any significant impact on the early release of systemic inflammatory markers.
Keywords:acute myocardial infarction  biomarker  cytokine  inflammation  reactive oxygen species
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