Effect of oxygen therapy on myocardial salvage in ST elevation myocardial infarction: the randomized SOCCER trial

Area of Science:

• Cardiology
• Emergency Medicine
• Medical Imaging

Background:

• Emerging evidence suggests potential adverse effects of oxygen administration in acute myocardial infarction (AMI).
• Optimal oxygen therapy for ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) remains under investigation.

Purpose of the Study:

• To evaluate the impact of supplemental oxygen versus room air on myocardial salvage in STEMI patients undergoing PCI.
• To assess infarct size and myocardium at risk using cardiac MRI (CMR) in this patient population.

Main Methods:

• A randomized-controlled trial involving normoxic STEMI patients conducted at two Swedish university hospitals.
• Patients were randomized in the ambulance to receive either high-flow oxygen (10 L/min) or room air until PCI completion.
• Cardiac MRI was performed 2-6 days post-inclusion to assess myocardial salvage index, infarct size, and myocardium at risk.

Main Results:

• No significant differences were observed in the myocardial salvage index between the oxygen group (53.9±25.1%) and the room air group (49.3±24.0%).
• Myocardium at risk (31.9±10.0% vs. 30.0±11.8% of left ventricle) and infarct size (15.6±10.4% vs. 16.0±11.0% of left ventricle) were similar in both groups.
• Patient characteristics at inclusion were comparable between the supplemental oxygen (n=46) and room air (n=49) groups.

Conclusions:

• High-flow oxygen administration did not demonstrate a significant effect on myocardial salvage or infarct size in STEMI patients undergoing acute PCI.
• These findings support the safety of withholding supplemental oxygen in normoxic STEMI patients.
• The study contributes to understanding optimal oxygen management strategies in acute coronary syndromes.