Hyperbaric oxygen and thrombolysis in myocardial infarction: The 'HOT MI' randomized multicenter study
Hyperbaric oxygen and thrombolysis in myocardial infarction: The 'HOT MI' randomized multicenter study
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DOI：
10.1159/000006832
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发表时间：
1998-01-01
期刊：
影响因子：
1.9
通讯作者：
Clarke, D
中科院分区：
文献类型：
--
作者：
Stavitsky, Y;Shandling, AH;Clarke, D
在之前的一项试点研究中，我们证明高压氧 (HBO) 辅助治疗对于急性心肌梗死 (AMI) 患者似乎是可行且安全的，并且可能导致肌酸磷酸激酶 (CPK) 上升减弱，疼痛和 ST 变化更快消退。这项随机多中心试验的目的是进一步评估这种治疗方法在人类受试者中的安全性和可行性。使用重组组织纤溶酶原激活剂 (rTPA) 或链激酶 (STK) 治疗的 AMI 患者被随机分配接受 HBO 联合 rTPA 或 STK 治疗，或单独接受 rTPA 或 STK 治疗。一项分析包括 112 名患者，其中 66 名患者患有下 AMI (p = NS)，其余患者患有前 AMI。 HBO 患者的 12 小时和 24 小时平均 CPK 降低约 7.5% (p = NS)。 HBO 组的疼痛缓解时间较短。对照组有 2 人死亡，HBO 治疗组有 1 人死亡。 HBO 组出院时的左心室射血分数 (LVEF) 为 51.7%，而对照组为 48.4% (p = NS)。对照组的 LVEF 为 43.4，而治疗组的 LVEF 为 47.6，大约提高了 10%（无显着差异）。 HBO 联合溶栓治疗对于 AMI 患者似乎是可行且安全的，并且可能导致 CPK 升高减弱、疼痛更快消退并改善射血分数。需要更多的研究来评估这种治疗的益处。
In a previous pilot study, we demonstrated that adjunctive treatment with hyperbaric oxygen (HBO) appears to be feasible and safe in patients with acute myocardial infarction (AMI) and may result in an attenuated rise in creatine phosphokinase (CPK), more rapid resolution of pain and ST changes. This randomized multicenter trial was organized to further assess the safety and feasibility of this treatment in human subjects. Patients with an AMI treated with recombinant tissue plasminogen activator (rTPA) or streptokinase (STK), were randomized to treatment with HBO combined with either rTPA or STK, or rTPA or STK alone. An analysis included 112 patients, 66 of whom had inferior AMIs (p = NS), The remainder of the patients had anterior AMIs. The mean CPK at 12 and 24 h was reduced in the HBO patients by approximately 7.5% (p = NS). Time to pain relief was shorter in the HBO group. There were 2 deaths in the control and 1 in those treated with HBO. The left ventricle ejection fraction (LVEF) on discharge was 51.7% in the HBO group as compared to 48.4% in the controls (p = NS). The LVEF of the controls was 43.4 as compared to 47.6 for those treated, approximately 10% better (no significant difference). Treatment with HBO in combination with thrombolysis appears to be feasible and safe for patients with AMI and may result in an attenuated CPK rise, more rapid resolution of pain and improved ejection fractions. More studies are needed to assess the benefits of this treatment.