Pump Up the O2: Is Supersaturated Oxygen Therapy the Holy Grail to Reduce Infarct Size in Anterior STEMI?

Despite increasing success in the race to rapidly open occluded coronary arteries from anterior ST-elevation myocardial infarction (STEMI), morbidity and mortality remains high with an incidence of heart failure of at least 10% at 1 year post MI and a direct correlation between infarct size and risk of developing heart failure post-MI.[1] Reducing infarct size in anterior MI has thus become the holy grail in interventional cardiology, yet multiple approaches—stem cell infusions, ischemic preconditioning, and use of mechanical support devices during STEMI interventions—have not demonstrated significant benefit.[1-3] Supersaturated oxygen delivery (SSO2) at the time of STEMI has the potential to significantly reduce infarct size, but despite evidence that it may reduce infarct size by 24%, the use of SSO2 has been relatively limited.[4, 5] In this issue of JSCAI Vilain and colleagues demonstrate the first cost-effectiveness analysis of SSO2 to reduce infarct size in anterior STEMI.[6]