Intracoronary supersaturated oxygen therapy after primary percutaneous coronary intervention in ST-segment elevation...

Supersaturated oxygen (SSO2) is a novel adjunctive treatment aims to reduce reperfusion injury after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). We conducted this study to evaluate the efficacy and safety of SSO2 therapy in patients with STEMI.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched Cochrane Central, Embase, PubMed, Scopus, and Web of Science for studies comparing SSO2 therapy post-PCI with PCI alone in adults with STEMI. Primary efficacy outcomes were infarct size and all-cause death. A random-effects model was used for analysis.

Six unique studies that enrolled 1591 patients were included [518 (32.5%) of whom received SSO2]. SSO2 therapy was associated with a reduction in infarct size compared with the control group [mean difference = -4.7% of left ventricular mass, 95% confidence interval (CI): -8.3 to -1.1%; P = 0.01], with the greatest benefit observed in patients reperfused within 6 h of symptom onset (mean difference = -6.0% of left ventricular mass, 95% CI: -8.9 to -3.0%). SSO2 therapy was also associated with reduced left ventricular end-systolic volume (mean difference = -19.9 ml, 95% CI: -33.7 to -6.2). The between-group difference in all-cause mortality was NS (P = 0.58); however, an association between SSO2 use and reduced all-cause death was present in the two studies with long-term (1-year) follow-up (risk ratio = 0.10, 95% CI: 0.01-0.77). No safety concerns were identified.

SSO2 administration in patients with STEMI after primary PCI was safe and was associated with reduced infarct size, particularly when administered within 6 h of symptom onset. This myocardial salvage was associated with improvement in left ventricular function Further randomized trials are needed to definitively establish the impact of SSO2 on mortality and heart failure.