6/28/23, 12:50 AM AVOID Pathway Feedback Search Clinical Topics Home Studies AVOID AVOID Disease ST-elevation myocardial infarction Trial question What is the role of supplemental oxygen therapy in patients with STEMI? Study design Multi-center Open label RCT Population Characteristics of study participants 21.4% female N = 638 78.6% male 638 patients (93 female, 348 male) Inclusion criteria: patients with STEMI diagnosed on paramedic 12-lead ECG Key exclusion criteria: oxygen saturation < 94% measured on pulse oximeter, bronchospasm requiring nebulized salbutamol therapy with oxygen, oxygen administration before randomization, or altered conscious state Interventions N=318 routine supplemental oxygen (via face mask at 8 L/min) N=320 restricted supplemental oxygen (no oxygen unless oxygen saturation < 94%, in which case oxygen was administered via nasal cannula (4 L/min) or face mask (8 L/min) to achieve an oxygen saturation of 94%) https://web.pathway.md/studies/recHZYMVN3EP0vyhD 1/2 6/28/23, 12:50 AM AVOID Pathway Primary outcome Mean peak creatine kinase 1948.0 U/L 1948 1543 1461.0 U/L 974.0 U/L 487.0 U/L Significant increase 0.0 U/L Routine supplemental oxygen Restricted supplemental oxygen Significant increase in mean peak CK (1948 U/L vs. 1543 U/L; MR 1.27, 95% CI 1.04 to 1.52) Secondary outcomes Significant increase in recurrent myocardial infarction (5.5% vs. 0.9%; RR 6.1, 95% CI 1.75 to 10.45) No significant difference in geometric mean peak cTnI in patients with confirmed STEMI (57.4 g/L vs. 48 g/L; RR 1.2, 95% CI 0.92 to 1.56) Safety outcomes No significant differences in mortality at hospital discharge (1.8% vs. 4.5%, p=0.11). Conclusion In patients with STEMI diagnosed on paramedic 12-lead ECG, routine supplemental oxygen was inferior to restricted supplemental oxygen with respect to mean peak CK. Reference Stub D, Smith K, Bernard S et al. Air Versus Oxygen in ST-Segment-Elevation Myocardial Infarction. Circulation. 2015 Jun 16;131(24):2143-50. Open reference URL https://web.pathway.md/studies/recHZYMVN3EP0vyhD 2/2