Takeaway
- Among normoxemic COPD patients with suspected acute myocardial infarction (AMI), supplemental oxygen therapy does not appear to affect 1-year outcomes.
Why this matters
- For all normoxemic comers with suspected AMI, DETO2X-AMI found no benefit to 1-year outcomes of oxygen therapy vs room air.
- COPD can alter patient response to oxygen.
Key results
- Patients with COPD vs without:
- All-cause mortality: 10.8% vs 4.8%.
- Cardiovascular mortality: 6.1% vs 3.5%.
- Rehospitalization for AMI or death: 15.5% vs 7.8%.
- Hospitalization for heart failure (HF) or death: 15.9% vs 10.57%.
- COPD cohort, oxygen therapy vs room air (HRs; 95% CIs):
- All-cause mortality: 0.99 (0.50-1.99; Pinteraction=.96);
- Cardiovascular mortality: 0.80 (0.32-2.04; Pinteraction=.59);
- Rehospitalization for AMI or death: 1.27 (0.71-2.28; Pinteraction=.46); and
- Hospitalization for HF or death: 1.08 (0.61-1.91; Pinteraction=.77).
Study design
- Prespecified subgroup analysis of DETO2X-AMI, which randomly assigned patients with suspected AMI to oxygen therapy vs room air (n=6629).
- Researchers compared oxygen vs room air in subset with COPD (n=155 and 141, respectively).
- Outcome: 1-year all-cause mortality.
- Funding: Swedish Research Council, Swedish Heart-Lung Foundation.
Limitations
- Few patients with COPD, few events, wide confidence intervals.
- COPD severities unknown.
- May not generalize to hypoxemic patients.
References
References