A Novel Treatment in Acute Anterior Myocardial Infarction: Supersaturated Oxygen Therapy
Journal of the American College of Cardiology
Background: Despite restoring macrovascular flow, microvascular ischemia can persist in cases of acute STEMI. Super saturated oxygen (SSO2) therapy in acute anterior STEMI due to a left anterior descending (LAD) artery occlusion allows the infusion of supersaturated oxygen into the coronary artery that results in reduction in infarct size. This case is the first successful treatment in Michigan utilizing this FDA-approved therapy. Case: A 53-year-old male presented with an anterolateral STEMI (Fig 1A) and ventricular tachycardia and fibrillation receiving multiple shocks. He underwent successful percutaneous coronary intervention (PCI) of his 100% proximal LAD occlusion (Fig 1D & 1E). Hand injection left ventriculogram showed an estimated EF of 40% (Fig 2A & 2B). SSO2 therapy was infused into the left main coronary artery for 60 minutes. His echocardiogram, 5 days after therapy, showed an EF of 75% (Fig 2C & 2D). His ECG 20 days later showed resolution of q waves (Fig 1C). His long term follow-up echo showed persistent improved EF of 70%. Decision-making: The AMIHOT trials showed that amongst patients with anterior STEMI who had PCI within 6 hours of symptoms, concomitant management with SSO2 led to a reduction in infarct size. This translated to a normalization in ECG and an improvement in EF in this case, which may have implications of decreased mortality and improved prognosis. Conclusion: Coronary SSO2 therapy following PCI in an anterior STEMI is safe and significantly reduces infarct size.
Sara K, Marie B, Saba A, James S. A Novel Treatment in Acute Anterior Myocardial Infarction: Supersaturated Oxygen Therapy. 2021;77(18):2408. Available from: https://doi.org/10.1016/S0735-1097(21)03763-3