Hyperbaric Oxygen Therapy Following Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.

INTRODUCTION: Hyperbaric oxygen therapy (HBOT) is a promising treatment modality for ischemic heart disease including myocardial infarction where outcomes are frequently poor despite early revascularization. OBJECTIVE: To compare single-photon emission computed tomography (SPECT) findings in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) treated with HBOT vs. control at 6 weeks. METHODS: In this pilot study, 24 patients were randomly allocated to HBOT (n = 13) and control groups (n = 11). Both groups underwent PPCI and were treated following the guidelines for STEMI management. The HBOT group received additional 15 and 90-minute HBOT sessions. All participants underwent SPECT at initial presentation (within 48 h of PPCI) and at follow up. RESULTS: Baseline characteristics were similar in both groups. The number of affected SPECT segments in the HBOT group at baseline and 6 weeks were 47.1 ±â€¯14.6% vs. 33.7 ±â€¯16.2%, respectively, with p = 0.039, and in the control group, the number of affected segment at these times were 55.5 ±â€¯19.5% vs. 45.9 ±â€¯17.9%, respectively, with p = 0.090. At follow-up, a decrease in the summed rest score was noted in both groups (HBOT: 20 ±â€¯6.0 vs. 12.7 ±â€¯8.1; p = 0.0017; control: 23 ±â€¯8.2 vs. 16.7 ±â€¯6.6; p = 0.031). The left ventricular ejection fraction in the HBOT group improved from 44 ±â€¯22.1% to 57.2 ±â€¯15.4% (p = 0.011) and in the control group from 45.9 ±â€¯18.2% to 55 ±â€¯12.1% (p = 0.044). CONCLUSIONS: HBOT use in STEMI patients was associated with an improvement in perfusion and an increase in ejection fraction following PPCI. These observations warrant a larger randomized clinical trial.