Acute cardiac care & resuscitation

Effects of mild hypercapnia on myocardial injury among ST-elevation myocardial infarction patients after out-of-hospital cardiac arrest: a exploratory post-hoc study of the TAME trial

ResuscitationPublished Post-hoc exploratory study of the TAME trial

Authors' conclusion

Among STEMI patients of the TAME trial, myocardial injury, in-hospital mortality, and neurological outcome at six months were not modified by allocation to targeted mild hypercapnia.

Study context

Population
Comatose adults after out-of-hospital cardiac arrest (OHCA) diagnosed with acute myocardial infarction (AMI), with STelevation myocardial infarction (STEMI)of 1700 TAME patients (49%) diagnosed with AMI, 593 had STEMI (73%), troponin levels available for 562 STEMI patients (95%)
Participants
810 adults
Comparison
Targeted mild hypercapnia or normocapnia
  • Mild hypercapnian = 287
  • Normocapnian = 306reference
Primary endpoint
Myocardial injury assessed by peak high-sensitivity cardiac troponin T (hs-cTnT) or cTnI levels during hospitalisation in STEMI patients
Follow-up
During hospitalisation

Primary result

As reported in the abstract

mild hypercapnia vs normocapniaRatio of geometric means (95% CI)
cTnI
1.18(0.79–1.77)
hs-cTnT
1.20(0.88–1.63)

Secondary outcomes

OutcomeMild hypercapniaNormocapniaRelative Risk (95% CI)
In-hospital mortality in STEMI patients39%40.5%0.97 (0.82–1.14)
Favourable neurological outcome · six months44.3%48.5%1.09 (0.92–1.29)

Lactate clearance · first 24 h

No difference in lactate clearance according to treatment allocation

All outcomes in successful percutaneous coronary intervention (PCI) STEMI patients (subgroup)

No significant differences in any outcomes according to treatment allocation

Original publication

Effects of mild hypercapnia on myocardial injury among ST-elevation myocardial infarction patients after out-of-hospital cardiac arrest: a exploratory post-hoc study of the TAME trial. Resuscitation. Published 21 January 2026. doi:10.1016/j.resuscitation.2026.110982

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