Oxygen Therapy Confers Little Benefit in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis.

Objective
We aimed to investigate the clinical benefit of oxygen therapy in patients with acute ST-segment elevation myocardial infarction (STEMI).


Methods
We searched PubMed, Embase and the Cochrane Library from database inception to June 2020 to identify randomized controlled trials (RCTs) on oxygen therapy in acute STEMI. Literature screening, data extraction and study quality assessment were independently carried out by the 2 investigators according to the predefined eligibility criteria, and RevMan 5.3 analysis software was utilized for all analyses.


Results
Finally, 5 RCTs with a total of 4824 patients with STEMI were eligible for further meta-analysis. The RCT results demonstrated that oxygen therapy exerted non-significant effects in reducing the risks for short-term all-cause mortality (risk ratio [RR] = 1.21; 95% CI, 0.80-1.53; P = .53), cardiac arrest (RR = 1.20; 95% CI, 0.94-1.54; P = .79), recurrent myocardial infarction (MI) (RR = 0.68; 95% CI, 0.43-1.08; P = .10) and cardiogenic shock (RR = 0.81; 95% CI, 0.58-1.15; P = .24) and the incidence of other outcome indicators of acute STEMI.


Conclusions
Oxygen therapy does not provide more benefits than adverse effects in patients with acute STEMI. Personalized oxygen treatment based on dynamic oxygen saturation is recommended in patients with hypoxia. Supplemental oxygen in patients with acute STEMI has no effect on reducing infarct size, and has no benefit in all-cause mortality, cardiogenic shock, etc.