title: One-year outcome of the sevoflurane in acute myocardial infarction randomized trial.
abstract: BACKGROUND
  Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction.
  
  
  METHODS
  In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask. In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year.
  
  
  RESULTS
  Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by single-photon emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 - 8] in the sevoflurane group and 2.5% [0 - 7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P < 0.001).
  
  
  CONCLUSIONS
  In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov ; identifier: NCT00971607.
authors: Western University, London, ON, Canada.|London Health Sciences Centre, London, ON, Canada.
authors: Shahar
authors: S
authors: Lavi
authors: London Health Sciences Centre, London, ON, Canada.
authors: Mistre
authors: M
authors: Alemayehu
authors: Western University, London, ON, Canada.|London Health Sciences Centre, London, ON, Canada.
authors: David
authors: D
authors: McCarty
authors: Western University, London, ON, Canada.|London Health Sciences Centre, London, ON, Canada.
authors: James
authors: J
authors: Warrington
authors: Western University, London, ON, Canada. ronit.lavi@lhsc.on.ca.|London Health Sciences Centre, London, ON, Canada. ronit.lavi@lhsc.on.ca.|Anesthesia & Perioperative Medicine, Schulich Medicine & Dentistry, London Health Sciences Centre, 339 Windermere Road, London, ON, N6A 5A5, Canada. ronit.lavi@lhsc.on.ca.
authors: Ronit
authors: R
authors: Lavi
mesh_terms: D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000494:pharmacology; D004311:Double-Blind Method; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010100:Oxygen / Q000008:administration & dosage; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D000077149:Sevoflurane; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D010100:Oxygen