One-year outcomes of supersaturated oxygen therapy in acute anterior myocardial infarction: The IC-HOT study

Background: Supersaturated oxygen (SSO₂) has recently been approved by the U.S. Food and Drug Administration for administration after primary percutaneous coronary intervention (pPCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI) based on its demonstration of infarct size reduction in the IC-HOT study. Objectives: To describe the 1-year clinical outcomes of intracoronary SSO₂ treatment after pPCI in patients with anterior STEMI. Methods: IC-HOT was a prospective, open-label, single-arm study in which 100 patients without cardiogenic shock undergoing successful pPCI of an occluded left anterior descending coronary artery were treated with a 60-min SSO₂ infusion. One-year clinical outcomes were compared with a propensity-matched control group of similar patients with anterior STEMI enrolled in the INFUSE-AMI trial. Results: Baseline and postprocedural characteristics were similar in the two groups except for pre-PCI thrombolysis in myocardial infarction 3 flow, which was less prevalent in patients treated with SSO₂ (9.6% vs. 22.9%, p =.02). Treatment with SSO₂ was associated with a lower 1-year rate of the composite endpoint of all-cause death or new-onset heart failure (HF) or hospitalization for HF (0.0% vs. 12.3%, p =.001). All-cause mortality, driven by cardiovascular mortality, and new-onset HF or HF hospitalization were each individually lower in SSO₂-treated patients. There were no significant differences between groups in the 1-year rates of reinfarction or clinically driven target vessel revascularization. Conclusions: Infusion of SSO₂ following pPCI in patients with anterior STEMI was associated with improved 1-year clinical outcomes including lower rates of death and new-onset HF or HF hospitalizations.