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Diabetes Care. 2019 Nov;42(11):2032-2041. doi: 10.2337/dc19-0590. Epub 2019 Aug 31.

Oxygen Therapy in Myocardial Infarction Patients With or Without Diabetes: A Predefined Subgroup Analysis From the DETO2X-AMI Trial.

Author information

1
Division of Endocrinology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
2
Cardiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
3
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
4
Cardiology, Department of Clinical Sciences, Lund University, Lund, Sweden.
5
Department of Health Sciences, University of Borås, Borås, Sweden.
6
Department of Molecular and Clinical Medicine and Sahlgrenska University Hospital Department of Cardiology, University of Gothenburg, Gothenburg, Sweden.
7
Division of Cardiology, Department of Medicine, Solna, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
8
Department of Medical and Health Sciences and Department of Cardiology, Linköping University, Linköping, Sweden.
9
Department of Cardiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
10
Cardiology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

Abstract

OBJECTIVE:

To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes.

RESEARCH DESIGN AND METHODS:

In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes.

RESULTS:

As expected, event rates were significantly higher in patients with diabetes compared with patients without diabetes (main composite end point: hazard ratio [HR] 1.60 [95% CI 1.32-1.93], P < 0.01). In patients with diabetes, the main composite end point occurred in 16.2% (72 of 445) allocated to oxygen as compared with 16.6% (81 of 489) allocated to ambient air (HR 0.93 [95% CI 0.67-1.27], P = 0.81). There was no statistically significant difference for the individual components of the composite end point or the rate of cardiovascular death up to 1 year. Likewise, corresponding end points in patients without diabetes were similar between the treatment groups.

CONCLUSIONS:

Despite markedly higher event rates in patients with MI and diabetes, oxygen therapy did not significantly affect 1-year all-cause death, cardiovascular death, or rehospitalization with MI or HF, irrespective of underlying diabetes, in line with the results of the entire study.

PMID:
31473600
DOI:
10.2337/dc19-0590

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