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Randomized comparison of early supplemental oxygen versus ambient air in patients with confirmed myocardial infarction : Sex-related outcomes from DETO2X-AMI

Alfredsson, Joakim ; James, Stefan K. ; Erlinge, David LU orcid ; Herlitz, Johan ; Fröbert, Ole ; Dworeck, Christian ; Redfors, Björn ; Arefalk, Gabriel ; Östlund, Ollie and Jernberg, Tomas , et al. (2021) In American Heart Journal 237. p.13-24
Abstract

Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI). Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex. Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to... (More)

Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI). Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex. Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to 21.4% in women allocated to ambient air (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.65-1.05). In men, the incidence was 13.6% in patients allocated to oxygen compared to 13.3% in patients allocated to ambient air (HR 1.03, 95% CI 0.86-1.23). No significant interaction in relation to sex was found (P=.16). Irrespective of allocated treatment, the composite endpoint occurred more often in women compared to men (19.7 vs 13.4%, HR 1.51; 95% CI, 1.30-1.75). After adjustment for age alone, there was no difference between the sexes (HR 1.06, 95% CI 0.91-1.24), which remained consistent after multivariate adjustment. Conclusion: Oxygen therapy in normoxemic MI patients did not significantly affect all-cause mortality or rehospitalization for MI or heart failure in women or men. The observed worse outcome in women was explained by differences in baseline characteristics, especially age.

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type
Contribution to journal
publication status
published
subject
in
American Heart Journal
volume
237
pages
12 pages
publisher
Mosby-Elsevier
external identifiers
  • scopus:85104119865
  • pmid:33689730
ISSN
0002-8703
DOI
10.1016/j.ahj.2021.03.001
language
English
LU publication?
yes
id
4130a2fd-c4a5-420f-bfc6-4c729a1413d1
date added to LUP
2021-04-26 08:40:04
date last changed
2022-08-11 21:45:26
@article{4130a2fd-c4a5-420f-bfc6-4c729a1413d1,
  abstract     = {{<p>Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI). Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex. Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to 21.4% in women allocated to ambient air (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.65-1.05). In men, the incidence was 13.6% in patients allocated to oxygen compared to 13.3% in patients allocated to ambient air (HR 1.03, 95% CI 0.86-1.23). No significant interaction in relation to sex was found (P=.16). Irrespective of allocated treatment, the composite endpoint occurred more often in women compared to men (19.7 vs 13.4%, HR 1.51; 95% CI, 1.30-1.75). After adjustment for age alone, there was no difference between the sexes (HR 1.06, 95% CI 0.91-1.24), which remained consistent after multivariate adjustment. Conclusion: Oxygen therapy in normoxemic MI patients did not significantly affect all-cause mortality or rehospitalization for MI or heart failure in women or men. The observed worse outcome in women was explained by differences in baseline characteristics, especially age.</p>}},
  author       = {{Alfredsson, Joakim and James, Stefan K. and Erlinge, David and Herlitz, Johan and Fröbert, Ole and Dworeck, Christian and Redfors, Björn and Arefalk, Gabriel and Östlund, Ollie and Jernberg, Tomas and Mars, Katarina and Haaga, Urban and Lindahl, Bertil and Swahn, Eva and Lawesson, Sofia Sederholm and Hofmann, Robin}},
  issn         = {{0002-8703}},
  language     = {{eng}},
  pages        = {{13--24}},
  publisher    = {{Mosby-Elsevier}},
  series       = {{American Heart Journal}},
  title        = {{Randomized comparison of early supplemental oxygen versus ambient air in patients with confirmed myocardial infarction : Sex-related outcomes from DETO2X-AMI}},
  url          = {{http://dx.doi.org/10.1016/j.ahj.2021.03.001}},
  doi          = {{10.1016/j.ahj.2021.03.001}},
  volume       = {{237}},
  year         = {{2021}},
}