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Oxygen Therapy in Myocardial Infarction Patients With or Without Diabetes : A Predefined Subgroup Analysis From the DETO2X-AMI Trial

Nyström, Thomas ; James, Stefan K. ; Lindahl, Bertil ; Östlund, Ollie ; Erlinge, David LU ; Herlitz, Johan ; Omerovic, Elmir ; Mellbin, Linda ; Alfredsson, Joakim and Fröbert, Ole , et al. (2019) In Diabetes Care 42(11). p.2032-2041
Abstract

OBJECTIVE: To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes. RESEARCH DESIGN AND METHODS: In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes. RESULTS: As... (More)

OBJECTIVE: To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes. RESEARCH DESIGN AND METHODS: In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes. RESULTS: As expected, event rates were significantly higher in patients with diabetes compared with patients without diabetes (main composite end point: hazard ratio [HR] 1.60 [95% CI 1.32-1.93], P < 0.01). In patients with diabetes, the main composite end point occurred in 16.2% (72 of 445) allocated to oxygen as compared with 16.6% (81 of 489) allocated to ambient air (HR 0.93 [95% CI 0.67-1.27], P = 0.81). There was no statistically significant difference for the individual components of the composite end point or the rate of cardiovascular death up to 1 year. Likewise, corresponding end points in patients without diabetes were similar between the treatment groups. CONCLUSIONS: Despite markedly higher event rates in patients with MI and diabetes, oxygen therapy did not significantly affect 1-year all-cause death, cardiovascular death, or rehospitalization with MI or HF, irrespective of underlying diabetes, in line with the results of the entire study.

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published
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Diabetes Care
volume
42
issue
11
pages
10 pages
publisher
American Diabetes Association
external identifiers
  • pmid:31473600
  • scopus:85073668548
ISSN
1935-5548
DOI
10.2337/dc19-0590
language
English
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yes
id
82220389-8f2e-4eb7-a7cf-d6cb39b436d0
date added to LUP
2019-10-30 07:49:58
date last changed
2019-12-10 08:16:27
@misc{82220389-8f2e-4eb7-a7cf-d6cb39b436d0,
  abstract     = {<p>OBJECTIVE: To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes. RESEARCH DESIGN AND METHODS: In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes. RESULTS: As expected, event rates were significantly higher in patients with diabetes compared with patients without diabetes (main composite end point: hazard ratio [HR] 1.60 [95% CI 1.32-1.93], P &lt; 0.01). In patients with diabetes, the main composite end point occurred in 16.2% (72 of 445) allocated to oxygen as compared with 16.6% (81 of 489) allocated to ambient air (HR 0.93 [95% CI 0.67-1.27], P = 0.81). There was no statistically significant difference for the individual components of the composite end point or the rate of cardiovascular death up to 1 year. Likewise, corresponding end points in patients without diabetes were similar between the treatment groups. CONCLUSIONS: Despite markedly higher event rates in patients with MI and diabetes, oxygen therapy did not significantly affect 1-year all-cause death, cardiovascular death, or rehospitalization with MI or HF, irrespective of underlying diabetes, in line with the results of the entire study.</p>},
  author       = {Nyström, Thomas and James, Stefan K. and Lindahl, Bertil and Östlund, Ollie and Erlinge, David and Herlitz, Johan and Omerovic, Elmir and Mellbin, Linda and Alfredsson, Joakim and Fröbert, Ole and Jernberg, Tomas and Hofmann, Robin},
  issn         = {1935-5548},
  language     = {eng},
  number       = {11},
  pages        = {2032--2041},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Oxygen Therapy in Myocardial Infarction Patients With or Without Diabetes : A Predefined Subgroup Analysis From the DETO2X-AMI Trial},
  url          = {http://dx.doi.org/10.2337/dc19-0590},
  doi          = {10.2337/dc19-0590},
  volume       = {42},
  year         = {2019},
}