section name header

Evidence summaries

Hyperbaric Oxygen Therapy for Acute Coronary Syndrome

Hyperbaric oxygen may reduce risk of death and have some effect on the adverse heart events in people with acute coronary syndrome. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 6 studies with a total of 665 subjects. There was a significant decrease in the risk of death with hyperbaric oxygen therapy (HBOT) (RR 0.58, 95% CI 0.36 to 0.92; 5 studies, n = 614). The extent of heart muscle damage was lower following HBOT, as shown by a lesser rise in muscle enzyme in the blood (MD 493 IU, P = 0.005) and a better LVEF (MD 5.5%, P = 0.001). There was evidence from individual trials of reductions in the risk of major adverse coronary events (MACE)(RR 0.12, 95% CI 0.02 to 0.85, 1 study, n = 61; NNT 4, 95% CI 3 to 10), re-infarction (RR 0.28, 95% CI 0.08 to 0.95; 1 study, n = 129) and dysrhythmias following HBOT (RR 0.59, 95% CI 0.39 to 0.89, 1 study, n = 208; NNT 6, 95% CI 3 to 24), and that the time to relief of pain was reduced with HBOT (MD 353 minutes shorter, 95% CI 219 to 488, 1 study, n = 81). One trial (n = 208) suggested a significant incidence of claustrophobia in single occupancy chambers of 15% (RR of claustrophobia with HBOT 31.6, 95%CI 1.92 to 521, P = 0.02). The authors state that the routine adjunctive use of HBOT in these patients cannot be justified by this review.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding) and by imprecise results (limited study size for each comparison).

    References

    • Bennett MH, Lehm JP, Jepson N. Hyperbaric oxygen therapy for acute coronary syndrome. Cochrane Database Syst Rev 2015;(7):CD004818. [PubMed].

Primary/Secondary Keywords