Hyperbaric oxygen therapy for acute coronary syndrome

Area of Science:

• Cardiology
• Hyperbaric Medicine
• Critical Care

Background:

• Acute coronary syndrome (ACS) is a life-threatening condition requiring effective treatments.
• Hyperbaric oxygen therapy (HBOT) enhances oxygen supply to ischemic heart tissue.
• Previous reviews on HBOT for ACS were published in 2004 and 2010.

Purpose of the Study:

• To evaluate the efficacy and safety of adjunctive HBOT in treating ACS.
• To assess HBOT's impact on mortality, major adverse cardiac events (MACE), and patient safety.
• To compare HBOT-inclusive regimens against standard care without HBOT.

Main Methods:

• Updated systematic search of multiple databases up to September 2014.
• Included randomized controlled trials comparing HBOT with standard care for ACS.
• Independent quality assessment, data extraction, and meta-analysis using risk ratios and mean differences.

Main Results:

• Six trials with 665 participants were included; no new trials since 2010.
• Low-quality evidence suggests HBOT associated with a 42% reduction in mortality risk (RR: 0.58).
• HBOT was generally well-tolerated; no neurological oxygen toxicity reported, but claustrophobia was noted.

Conclusions:

• Limited evidence suggests HBOT may reduce mortality, myocardial damage, and MACE in ACS patients.
• Methodological limitations and small trial sizes necessitate cautious interpretation.
• High-quality, powered trials are needed to confirm HBOT's benefits and identify suitable patient populations.