Hyperoxia and oxidative stress may be associated with increased risk of myocardial injury. In this issue of Anesthesiology, Holse and members of the VIXIE (VitamIn and oXygen Interventions and cardiovascular Events) Trial Group report the results of a randomized clinical trial examining the impact of hyperoxia and the antioxidants vitamin C and N-acetylcysteine on the degree of myocardial injury after noncardiac surgery. In an accompanying editorial, Nagele discusses the need for more well-designed trials like VIXIE to definitively answer important clinical questions. Cover Illustration: A. Johnson, Vivo Visuals Studio.

  • Holse et al.: Hyperoxia and Antioxidants for Myocardial Injury in Noncardiac Surgery: A 2 × 2 Factorial, Blinded, Randomized Clinical Trial, p. 408

  • Nagele: The Importance of Definitive Trials: The VIXIE Trial, p. 403