In MI, Supplemental Oxygen Use Worsens Outcomes

Despite guideline recommendations, supplemental oxygen use increases the risk for re-infarction in patients who are hospitalized for myocardial infarction (MI), according to research being presented at CHEST 2018.

The report, authored by Dr Ravi Kanth Velagapudi and colleagues, will be presented on Wednesday, October 10, at CHEST Annual Meeting 2018 in San Antonio. 

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Until recently, standard treatment for patients with MI was the routine use of oxygen. However, recent studies have shown that there is no benefit to the patient, with the AVOID study even showing that the routine use of oxygen can increase the 6-month myocardial infarct size.

With these inconsistent results, Velagapudi and colleagues analyzed patient records from online databases, including PubMed and Scopus. 

In all, 914 patients were included in the analysis, with 449 of those having used supplemental oxygen.

While the infarcted myocardial mass, percent infarct mass, ejection fraction, and in-hospital mortality between the 2 groups were not significantly different, the researchers did find a significant increase in the incidence of re-infarction—4.92% for those who used supplemental oxygen compared with 0.73% for those who did not.

“Regular use of supplemental oxygen in MI without hypoxia is associated with adverse clinical outcome[s] secondary to increased rates of re-infarction,” the researchers concluded.

“There is uncertainty regarding the use of supplemental oxygen in patients with MI without heart failure or dyspnea in the recent guidelines. In light of our evidence of increased adverse clinical outcome[s], we think the guidelines should actually now recommend against the regular supplemental use of oxygen.”

—Colleen Murphy

Reference:

Velagapudi RV, Upadhaya S, Chintalapati SPK, Bachuwa G. Routine use of supplemental oxygen in patients with myocardial infarction without hypoxia is associated with higher rates of re-infarction: a meta-analysis. Paper presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX. https://journal.chestnet.org/article/S0012-3692(18)31260-1/abstract. Accessed October 9, 2018.