Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction
Objective Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of oxygen exposure on myocardial injury after STEMI. Methods Descriptive analysis of data from a multicen...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
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BMJ Publishing Group
2016
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| Online Access: | http://hdl.handle.net/20.500.11937/9109 |
| _version_ | 1848745854101356544 |
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| author | Nehme, Z. Stub, D. Bernard, S. Stephenson, M. Bray, Janet Cameron, P. Meredith, I. Barger, B. Ellims, A. Taylor, A. Kaye, D. Smith, K. |
| author_facet | Nehme, Z. Stub, D. Bernard, S. Stephenson, M. Bray, Janet Cameron, P. Meredith, I. Barger, B. Ellims, A. Taylor, A. Kaye, D. Smith, K. |
| author_sort | Nehme, Z. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of oxygen exposure on myocardial injury after STEMI. Methods Descriptive analysis of data from a multicentre, prospective, randomised, controlled trial of 441 patients with STEMI randomised to supplemental oxygen therapy or room air breathing. The primary endpoint was myocardial infarct size as aeed by cardiac biomarkers, troponin (cTnI) and creatine kinase (CK). Oxygen therapy was commenced by paramedics, and continued for up to 12 h postintervention in hospital. Supplemental oxygen exposure was calculated as the area under the dose×time curve for oxygen administration over the first 12 h, and then aeed for its aociation with cTnI/CK release using multivariable linear regreion. Results The median supplemental oxygen exposure was 1746 L (IQR: 960-2858). After adjustment for potential confounders, every 100 L increase in oxygen exposure in the first 12 h was aociated with a 1.4% (95% CI 0.6% to 2.2%, p<0.001) and 1.2% (95% CI 0.7% to 1.8%, p<0.001) increase in the mean peak cTnI and CK, respectively. Excluding patients who developed cardiogenic shock, recurrent myocardial infarction or desaturations (SpO2<94%) during admiion, every 100 L increase in oxygen exposure was aociated with a 1.2% (95% CI 0.2% to 2.1%, p=0.01) and 1.0% (95% CI 0.3% to 1.7%, p=0.003) increase in the mean peak cTnI and CK, respectively. The median supplemental oxygen exposure of 1746 L would result in a 21% (95% CI 3% to 37%) increase in infarct size according to the cTnI profile. Conclusions Supplemental oxygen exposure in the first 12 h after STEMI was aociated with a clinically significant increase in cTnI and CK release. |
| first_indexed | 2025-11-14T06:23:58Z |
| format | Journal Article |
| id | curtin-20.500.11937-9109 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:23:58Z |
| publishDate | 2016 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-91092017-09-13T14:50:54Z Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction Nehme, Z. Stub, D. Bernard, S. Stephenson, M. Bray, Janet Cameron, P. Meredith, I. Barger, B. Ellims, A. Taylor, A. Kaye, D. Smith, K. Objective Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of oxygen exposure on myocardial injury after STEMI. Methods Descriptive analysis of data from a multicentre, prospective, randomised, controlled trial of 441 patients with STEMI randomised to supplemental oxygen therapy or room air breathing. The primary endpoint was myocardial infarct size as aeed by cardiac biomarkers, troponin (cTnI) and creatine kinase (CK). Oxygen therapy was commenced by paramedics, and continued for up to 12 h postintervention in hospital. Supplemental oxygen exposure was calculated as the area under the dose×time curve for oxygen administration over the first 12 h, and then aeed for its aociation with cTnI/CK release using multivariable linear regreion. Results The median supplemental oxygen exposure was 1746 L (IQR: 960-2858). After adjustment for potential confounders, every 100 L increase in oxygen exposure in the first 12 h was aociated with a 1.4% (95% CI 0.6% to 2.2%, p<0.001) and 1.2% (95% CI 0.7% to 1.8%, p<0.001) increase in the mean peak cTnI and CK, respectively. Excluding patients who developed cardiogenic shock, recurrent myocardial infarction or desaturations (SpO2<94%) during admiion, every 100 L increase in oxygen exposure was aociated with a 1.2% (95% CI 0.2% to 2.1%, p=0.01) and 1.0% (95% CI 0.3% to 1.7%, p=0.003) increase in the mean peak cTnI and CK, respectively. The median supplemental oxygen exposure of 1746 L would result in a 21% (95% CI 3% to 37%) increase in infarct size according to the cTnI profile. Conclusions Supplemental oxygen exposure in the first 12 h after STEMI was aociated with a clinically significant increase in cTnI and CK release. 2016 Journal Article http://hdl.handle.net/20.500.11937/9109 10.1136/heartjnl-2015-308636 BMJ Publishing Group restricted |
| spellingShingle | Nehme, Z. Stub, D. Bernard, S. Stephenson, M. Bray, Janet Cameron, P. Meredith, I. Barger, B. Ellims, A. Taylor, A. Kaye, D. Smith, K. Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title | Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title_full | Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title_fullStr | Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title_full_unstemmed | Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title_short | Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction |
| title_sort | effect of supplemental oxygen exposure on myocardial injury in st-elevation myocardial infarction |
| url | http://hdl.handle.net/20.500.11937/9109 |