Update on Cardioprotective Strategies for STEMI: Focus on Supersaturated Oxygen Delivery.
JACC Basic Transl Sci
; 6(12): 1021-1033, 2021 Dec.
Article
em En
| MEDLINE
| ID: mdl-35024508
ABSTRACT
Despite the fact that door-to-balloon times have been greatly reduced, the rates of death and the incidence of heart failure in patients with ST-segment elevation myocardial infarction (MI) have plateaued. There is still an unmet need to further reduce MI size in the reperfusion era. Most adjunctive therapies to enhance myocardial salvage have failed, but some have shown promise. Currently, the only adjunctive therapy in a pivotal trial that has demonstrated reductions in infarct size is localized delivery of supersaturated oxygen (SSO2) therapy. This review provides background on prior infarct size reduction efforts. The authors describe the preclinical data that shows the effectiveness of SSO2 in reducing MI size, improving regional myocardial blood flow and cardiac function, and reducing adverse left ventricular remodeling-presumably by reducing patchy areas of residual ischemia within the reperfused risk zone. Potential mechanisms by which SSO2 is beneficial are described, including the delivery of high levels of dissolved oxygen through plasma to ischemic, but viable, vascular and myocardial cells, thus allowing their survival and function. The authors then describe the SSO2 clinical trials, demonstrating that in patients with anterior ST-segment elevation MI, SSO2 therapy safely and effectively reduces infarct size, improves cardiac function, and reduces adverse left ventricular remodeling.
AMI, acute myocardial infarction; CMR, cardiac magnetic resonance; FDA, Food and Drug Administration; HF, heart failure; LAD, left anterior descending coronary artery; LM, left main coronary artery; LV function; LV remodeling; LV, left ventricular; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NACE, net adverse clinical events; PCI, percutaneous coronary intervention; Pao2, partial pressure of oxygen; SPECT, single-photon emission computed tomography; SSO2, supersaturated oxygen; ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; TIMI, Thrombolysis In Myocardial Infarction; TVR, target vessel revascularization; myocardial infarct size reduction; supersaturated oxygen
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01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article