Supersaturated Oxygen Therapy for Coronary Microvascular Dysfunction in Patients With ST-Segment Elevation Myocardial...

Area of Science:

• Cardiology
• Interventional Cardiology
• Myocardial Infarction Research

Background:

• Supersaturated oxygen (SSO2) therapy is an emerging treatment shown to reduce infarct size and improve myocardial remodeling post-percutaneous coronary intervention (PCI).
• The mechanism is thought to involve improvement in coronary microvascular dysfunction (CMD), but current protocols require prolonged patient confinement.
• Stratified medicine approaches based on CMD severity could optimize SSO2 therapy application in ST-segment elevation myocardial infarction (STEMI) patients.

Purpose of the Study:

• To investigate the efficacy of SSO2 therapy in improving CMD.
• To assess the impact of SSO2 therapy on CMD in patients experiencing anterior STEMI.
• To explore the potential for CMD severity stratification in guiding SSO2 therapy.

Main Methods:

• A prospective pilot study enrolled consecutive patients with acute anterior STEMI undergoing primary PCI.
• SSO2 therapy was administered after successful PCI, involving hyper-oxygenation of blood and delivery via a dedicated catheter.
• Coronary microvascular dysfunction was assessed by comparing the angiography-derived index of microcirculation resistance (Angio-IMR) before and after SSO2 therapy.

Main Results:

• Twelve male patients (mean age 64) completed the procedure without complications.
• Median Angio-IMR significantly decreased from 44.5 before SSO2 therapy to 23 after therapy (P = .003).
• A statistically significant reduction in Angio-IMR was observed in patients with a baseline Angio-IMR >40 compared to those without (P = .004).

Conclusions:

• SSO2 therapy effectively improves CMD, as measured by Angio-IMR, in patients with anterior STEMI.
• The therapeutic benefit of SSO2 appears most pronounced in patients with high baseline Angio-IMR (>40).
• These findings support the development of stratified medicine strategies utilizing Angio-IMR to guide SSO2 therapy in STEMI patients with severe CMD.