This Article Figures Only Full Text Full Text (PDF) View Study Organization All Versions of this Article: j.jacc.2007.01.099v1 50/5/397    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by O’Neill, W. W. Search for Related Content PubMed Articles by O’Neill, W. W. Related Collections Related Article

CLINICAL RESEARCH: CLINICAL TRIAL

Acute Myocardial Infarction With Hyperoxemic Therapy (AMIHOT)

A Prospective, Randomized Trial of Intracoronary Hyperoxemic Reperfusion After Percutaneous Coronary Intervention

William W. O’Neill, MD^_*,1,_*, Jack L. Martin, MD^,1, Simon R. Dixon, MBChB, Antonio L. Bartorelli, MD, Daniela Trabattoni, MD, Pranobe V. Oemrawsingh, MD^||, Douwe E. Atsma, MD^||, Michael Chang, MD^¶, William Marquardt, MD^¶, Jae K. Oh, MD^#, Mitchell W. Krucoff, MD^_**, Raymond J. Gibbons, MD^#, J. Richard Spears, MD^,2 for the AMIHOT Investigators

^_* University of Miami, Miami, Florida
Sharpe-Strumia Research Foundation of the Bryn Mawr Hospital, Main Line Health System, Bryn Mawr, Pennsylvania
William Beaumont Hospital, Royal Oak, Michigan
Centro Cardiologico Monzino, University of Milan, Milan, Italy
^|| Leiden University Medical Center, Leiden, the Netherlands
^¶ Mercy General Hospital, Sacramento, California
^# Mayo Clinic, Rochester, Minnesota
^_** Duke Clinical Research Institute, Durham, North Carolina
Wayne State University, Detroit, Michigan.

Manuscript received December 22, 2005; revised manuscript received December 22, 2006, accepted January 2, 2007.

^_* Reprint requests and correspondence: Dr. William W. O’Neill, Leonard M. Miller School of Medicine, University of Miami, P.O. Box 016099 (R.699), Miami, Florida 33101. (Email: woneill{at}med.miami.edu).

Objectives: This study sought to determine whether hyperoxemic reperfusion with aqueous oxygen (AO) improves recovery of ventricular function after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).

Background: Hyperbaric oxygen reduces myocardial injury and improves ventricular function when administered during ischemia-reperfusion.

Methods: In a prospective, multicenter study, 269 patients with acute anterior or large inferior AMI undergoing primary or rescue PCI (<24 h from symptom onset) were randomly assigned after successful PCI to receive hyperoxemic reperfusion (treatment group) or normoxemic blood autoreperfusion (control group). Hyperoxemic reperfusion was performed for 90 min using intracoronary AO. The primary end points were final infarct size at 14 days, ST-segment resolution, and regional wall motion score index of the infarct zone at 3 months.

Results: At 30 days, the incidence of major adverse cardiac events was similar between the control and AO groups (5.2% vs. 6.7%, p = 0.62). There was no significant difference in the incidence of the primary end points between the study groups. In post-hoc analysis, anterior AMI patients reperfused <6 h who were treated with AO had a greater improvement in regional wall motion ( wall motion score index = 0.54 in control group vs. 0.75 in AO group, p = 0.03), smaller infarct size (23% of left ventricle in control group vs. 9% of left ventricle in AO group, p = 0.04), and improved ST-segment resolution compared with normoxemic controls.

Conclusions: Intracoronary hyperoxemic reperfusion was safe and well tolerated after PCI for AMI, but did not improve regional wall motion, ST-segment resolution, or final infarct size. A possible treatment effect was observed in anterior AMI patients reperfused <6 h of symptom onset.

Abbreviations and Acronyms   AM I = acute myocardial infarction   AO = aqueous oxygen   PCI = percutaneous coronary intervention   RWMSI = regional wall motion score index   TIMI = Thrombolysis In Myocardial Infarction

Related Article

The Search for Myocardial Protection: Is There Still Hope?

Christopher B. Granger and Manesh R. Patel
J. Am. Coll. Cardiol. 2007 50: 406-408. [Full Text] [PDF]

This article has been cited by other articles:

				G. W. Stone Angioplasty Strategies in ST-Segment-Elevation Myocardial Infarction: Part II: Intervention After Fibrinolytic Therapy, Integrated Treatment Recommendations, and Future Directions Circulation, July 29, 2008; 118(5): 552 - 566. [Full Text] [PDF]

				S. R. Dixon, C. L. Grines, and W. W. O'Neill The year in interventional cardiology. J. Am. Coll. Cardiol., June 17, 2008; 51(24): 2355 - 2369. [Full Text] [PDF]

				M. Valgimigli, G. Campo, G. Percoco, L. Bolognese, C. Vassanelli, S. Colangelo, N. de Cesare, A. E. Rodriguez, M. Ferrario, R. Moreno, et al. Comparison of Angioplasty With Infusion of Tirofiban or Abciximab and With Implantation of Sirolimus-Eluting or Uncoated Stents for Acute Myocardial Infarction: The MULTISTRATEGY Randomized Trial JAMA, April 16, 2008; 299(15): 1788 - 1799. [Abstract] [Full Text] [PDF]

				H. Thibault, C. Piot, P. Staat, L. Bontemps, C. Sportouch, G. Rioufol, T. T. Cung, E. Bonnefoy, D. Angoulvant, J.-F. Aupetit, et al. Long-Term Benefit of Postconditioning Circulation, February 26, 2008; 117(8): 1037 - 1044. [Abstract] [Full Text] [PDF]

				Direct Inhibition of {delta}-Protein Kinase C Enzy Intracoronary KAI-9803 as an Adjunct to Primary Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction Circulation, February 19, 2008; 117(7): 886 - 896. [Abstract] [Full Text] [PDF]

				C. B. Granger and M. R. Patel The Search for Myocardial Protection: Is There Still Hope? J. Am. Coll. Cardiol., July 31, 2007; 50(5): 406 - 408. [Full Text] [PDF]