Supplemental oxygen in patients without hypoxia in ST segment elevation myocardial infarction increases myocardial injury and infarct size

Commentary on : Stub D, Smith K, Bernard S, et al. AVOID Investigators. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation 2015;131:2143–50.[ OpenUrl][1][Abstract/FREE Full Text][2] In patients with ST segmentelevation myocardial infarction (STEMI), timely reperfusion, best obtained with primary percutaneous coronary intervention (pPCI), is a mainstay to reduce infarct size (IS) and improve clinical outcome. Routine oxygen administration in normoxic patients with STEMI before pPCI, while mentioned by international guidelines,1 is not supported by randomised evidence. Stub and colleagues performed the AVOID study to compare oxygen supplementation (8 L/min) versus no supplementation in patients with STEMI undergoing primary PCI. The authors conducted a multicentre prospective randomised controlled trial in Melbourne, Australia. Patients were screened and randomised by paramedics: any patient with chest pain <12 h and ECG evidence of STEMI was eligible. Patients … [1]: { openurl}?query=rft.jtitle%253DCirculation%26rft_id%253Dinfo%253Adoi%252F10.1161%252FCIRCULATIONAHA.114.014494%26rft_id%253Dinfo%253Apmid%252F26002889%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=circulationaha&resid=131/24/2143&atom=%2Febmed%2Fearly%2F2015%2F11%2F05%2Febmed-2015-110245.atom