Inhaled Xenon Attenuates Myocardial Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest The Xe-Hypotheca Trial

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Arola , O , Saraste , A , Laitio , R , Airaksinen , J , Hynninen , M , Bäcklund , M , Ylikoski , E , Wennervirta , J , Pietila , M , Roine , R O , Harjola , V-P , Niiranen , J , Korpi , K , Varpula , M , Scheinin , H , Maze , M , Vahlberg , T , Laitio , T & Xe-HYPOTHECA Study Grp 2017 , ' Inhaled Xenon Attenuates Myocardial Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest The Xe-Hypotheca Trial ' , Journal of the American College of Cardiology , vol. 70 , no. 21 , pp. 2652-2660 . https://doi.org/10.1016/j.jacc.2017.09.1088

Title: Inhaled Xenon Attenuates Myocardial Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest The Xe-Hypotheca Trial
Author: Arola, Olli; Saraste, Antti; Laitio, Ruut; Airaksinen, Juhani; Hynninen, Marja; Bäcklund, Minna; Ylikoski, Emmi; Wennervirta, Johanna; Pietila, Mikko; Roine, Risto O.; Harjola, Veli-Pekka; Niiranen, Jussi; Korpi, Kirsi; Varpula, Marjut; Scheinin, Harry; Maze, Mervyn; Vahlberg, Tero; Laitio, Timo; Xe-HYPOTHECA Study Grp
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, Department of Medicine
Date: 2017-11-28
Language: eng
Number of pages: 9
Belongs to series: Journal of the American College of Cardiology
ISSN: 0735-1097
URI: http://hdl.handle.net/10138/298163
Abstract: BACKGROUND The authors previously reported that inhaled xenon combined with hypothermia attenuates brain white matter injury in comatose survivors of out-of-hospital cardiac arrest (OHCA). OBJECTIVES A pre-defined secondary objective was to assess the effect of inhaled xenon on myocardial ischemic damage in the same study population. METHODS A total of 110 comatose patients who had experienced OHCA from a cardiac cause were randomized to receive either inhaled xenon (40% end-tidal concentration) combined with hypothermia (33 degrees C) for 24 h (n = 55; xenon group) or hypothermia treatment alone (n = 55; control group). Troponin-T levels were measured at hospital admission, and at 24 h, 48 h, and 72 h post-cardiac arrest. All available cases were analyzed for troponin-T release. RESULTS Troponin-T measurements were available from 54 xenon patients and 54 control patients. The baseline characteristics did not differ significantly between the groups. After adjustments for age, sex, study site, primary coronary percutaneous intervention (PCI), and norepinephrine dose, the mean +/- SD post-arrival incremental change of the ln-transformed troponin-T at 72 h was 0.79 +/- 1.54 in the xenon group and 1.56 +/- 1.38 in the control group (adjusted mean difference -0.66; 95% confidence interval: -1.16 to -0.16; p = 0.01). The effect of xenon on the change in the troponin-T values did not differ in patients with or without PCI or in those with a diagnosis of ST-segment elevation myocardial infarction (group by PCI or ST-segment elevation myocardial infarction interaction effect; p = 0.86 and p = 0.71, respectively). CONCLUSIONS Among comatose survivors of OHCA, in comparison with hypothermia alone, inhaled xenon combined with hypothermia suggested a less severe myocardial injury as demonstrated by the significantly reduced release of troponin-T. (C) 2017 by the American College of Cardiology Foundation.
Subject: cardioprotection
hypothermia
out-of-hospital cardiac arrest
xenon
MITOCHONDRIAL PERMEABILITY TRANSITION
TARGETED TEMPERATURE MANAGEMENT
EUROPEAN RESUSCITATION COUNCIL
ISCHEMIA-REPERFUSION INJURY
HEART IN-VIVO
PROPOFOL ANESTHESIA
ELECTIVE SURGERY
INFARCT SIZE
RAT HEARTS
ISOFLURANE
3121 General medicine, internal medicine and other clinical medicine
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