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Effect of oxygen therapy on chest pain in patients with ST elevation myocardial infarction : results from the randomized SOCCER trial

Khoshnood, Ardavan LU ; Akbarzadeh, Mahin LU ; Carlsson, Marcus LU ; Sparv, David LU ; Bhiladvala, Pallonji LU ; Mokhtari, Arash LU ; Erlinge, David LU and Ekelund, Ulf LU (2018) In Scandinavian Cardiovascular Journal 52(2). p.69-73
Abstract

Objective. Oxygen (O2) have been a cornerstone in the treatment of acute myocardial infarction. Studies have been inconclusive regarding the cardiovascular and analgesic effects of oxygen in these patients. In the SOCCER trial, we compared the effects of oxygen treatment versus room air in patients with ST-elevation myocardial infarction (STEMI). There was no difference in myocardial salvage index or infarct size assessed with cardiac magnetic resonance imaging. In the present subanalysis, we wanted to evaluate the effect of O2 on chest pain in patients with STEMI. Design. Normoxic patients with first time STEMI were randomized in the ambulance to standard care with 10 l/min O2 or room air until the end... (More)

Objective. Oxygen (O2) have been a cornerstone in the treatment of acute myocardial infarction. Studies have been inconclusive regarding the cardiovascular and analgesic effects of oxygen in these patients. In the SOCCER trial, we compared the effects of oxygen treatment versus room air in patients with ST-elevation myocardial infarction (STEMI). There was no difference in myocardial salvage index or infarct size assessed with cardiac magnetic resonance imaging. In the present subanalysis, we wanted to evaluate the effect of O2 on chest pain in patients with STEMI. Design. Normoxic patients with first time STEMI were randomized in the ambulance to standard care with 10 l/min O2 or room air until the end of the percutaneous coronary intervention (PCI). The ambulance personnel noted the patients´ chest pain on a visual analog scale (VAS; 1-10) before randomization and after the transport but before the start of the PCI, and also registered the amount of morphine given. Results. 160 patients were randomized to O2 (n = 85) or room air (n = 75). The O2 group had a higher median VAS at randomization than the air group (7.0 ± 2.3 vs 6.0 ± 2.9; p = .02) and also received a higher median total dose of morphine (5.0 mg ± 4.4 vs 4.0 mg ± 3.7; p = .02). There was no difference between the O2 and air groups in VAS at the start of the PCI (4.0 ± 2.4 vs 3.0 ± 2.5; p = .05) or in the median VAS decrease from randomization to the start of the PCI (−2.0 ± 2.2 vs −1.0 ± 2.9; p = .18). Conclusion. Taken together with previously published data, these results do not support a significant analgesic effect of oxygen in patients with STEMI. European Clinical Trials Database (EudraCT): 2011-001452-11. ClinicalTrials.gov Identifier: NCT01423929

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Oxygen Therapy, STEMI, ST Elevation Myocardial Infarction, Pain
in
Scandinavian Cardiovascular Journal
volume
52
issue
2
pages
5 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85041911881
ISSN
1401-7431
DOI
10.1080/14017431.2018.1439183
language
English
LU publication?
yes
id
ddc8b26c-c46d-4bcf-94c8-006d93f1455a
date added to LUP
2018-03-01 09:53:21
date last changed
2018-06-04 10:12:55
@article{ddc8b26c-c46d-4bcf-94c8-006d93f1455a,
  abstract     = {<p>Objective. Oxygen (O<sub>2</sub>) have been a cornerstone in the treatment of acute myocardial infarction. Studies have been inconclusive regarding the cardiovascular and analgesic effects of oxygen in these patients. In the SOCCER trial, we compared the effects of oxygen treatment versus room air in patients with ST-elevation myocardial infarction (STEMI). There was no difference in myocardial salvage index or infarct size assessed with cardiac magnetic resonance imaging. In the present subanalysis, we wanted to evaluate the effect of O<sub>2</sub> on chest pain in patients with STEMI. Design. Normoxic patients with first time STEMI were randomized in the ambulance to standard care with 10 l/min O<sub>2</sub> or room air until the end of the percutaneous coronary intervention (PCI). The ambulance personnel noted the patients´ chest pain on a visual analog scale (VAS; 1-10) before randomization and after the transport but before the start of the PCI, and also registered the amount of morphine given. Results. 160 patients were randomized to O<sub>2</sub> (n = 85) or room air (n = 75). The O<sub>2</sub> group had a higher median VAS at randomization than the air group (7.0 ± 2.3 vs 6.0 ± 2.9; p = .02) and also received a higher median total dose of morphine (5.0 mg ± 4.4 vs 4.0 mg ± 3.7; p = .02). There was no difference between the O<sub>2</sub> and air groups in VAS at the start of the PCI (4.0 ± 2.4 vs 3.0 ± 2.5; p = .05) or in the median VAS decrease from randomization to the start of the PCI (−2.0 ± 2.2 vs −1.0 ± 2.9; p = .18). Conclusion. Taken together with previously published data, these results do not support a significant analgesic effect of oxygen in patients with STEMI. European Clinical Trials Database (EudraCT): 2011-001452-11. ClinicalTrials.gov Identifier: NCT01423929</p>},
  author       = {Khoshnood, Ardavan and Akbarzadeh, Mahin and Carlsson, Marcus and Sparv, David and Bhiladvala, Pallonji and Mokhtari, Arash and Erlinge, David and Ekelund, Ulf},
  issn         = {1401-7431},
  keyword      = {Oxygen Therapy,STEMI,ST Elevation Myocardial Infarction,Pain},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {69--73},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {Effect of oxygen therapy on chest pain in patients with ST elevation myocardial infarction : results from the randomized SOCCER trial},
  url          = {http://dx.doi.org/10.1080/14017431.2018.1439183},
  volume       = {52},
  year         = {2018},
}