AIMS: Prior evaluations of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have suggested variability in treatment effect related to core temperature at the time of reperfusion, to infarct location and time from symptom onset to reperfusion. Recent results from a randomised feasibility study suggest rapid induction of hypothermia in primary PCI results in a significant reduction in infarct size (IS). METHODS AND RESULTS: Outcomes from two randomised trials of hypothermia in primary PCI were pooled to examine IS as a percentage of left ventricular myocardium assessed by SPECT or magnetic resonance imaging. Compared with controls (n=103), hypothermia (n=94) was associated with a significant 24% relative reduction (RR) in IS (10.7±1.3% vs. 14.1±1.6%, mean±SEM, p=0.049). Among hypothermia-treated patients for whom core temperature <35C° was achieved before reperfusion, IS was reduced by 37% (8.8±1.7% vs. 14.1±1.6%, p=0.01), a benefit observed for both anterior (14.9±2.9% vs. 22.2±2.7%, RR 33%; p=0.03) and inferior infarcts (4.5±1.4% vs. 7.7±1.3%, RR 42%; p=0.04). CONCLUSIONS: In a pooled analysis of randomised trials evaluating adjunctive hypothermia in primary PCI, achievement of core body temperature <35°C before reperfusion may reduce infarct size with a similar efficacy for both anterior and inferior MI.
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AIMS: Prior evaluations of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have suggested variability in treatment effect related to core temperature at the time of reperfusion, to infarct location and time from symptom onset to reperfusion. Recent results from a randomised feasibility study suggest rapid induction of hypothermia in primary PCI results in a significant reduction in infarct size (IS). METHODS AND RESULTS: Outcomes from two randomised trials of hypothermia in primary PCI were pooled to examine IS as a percentage of left ventricular myocardium assessed by SPECT or magnetic resonance imaging. Compared with controls (n=103), hypothermia (n=94) was associated with a significant 24% relative reduction (RR) in IS (10.7±1.3% vs. 14.1±1.6%, mean±SEM, p=0.049). Among hypothermia-treatedpatients for whom core temperature <35C° was achieved before reperfusion, IS was reduced by 37% (8.8±1.7% vs. 14.1±1.6%, p=0.01), a benefit observed for both anterior (14.9±2.9% vs. 22.2±2.7%, RR 33%; p=0.03) and inferior infarcts (4.5±1.4% vs. 7.7±1.3%, RR 42%; p=0.04). CONCLUSIONS: In a pooled analysis of randomised trials evaluating adjunctive hypothermia in primary PCI, achievement of core body temperature <35°C before reperfusion may reduce infarct size with a similar efficacy for both anterior and inferior MI.
Authors: Martin Annborn; John Bro-Jeppesen; Niklas Nielsen; Susann Ullén; Jesper Kjaergaard; Christian Hassager; Michael Wanscher; Jan Hovdenes; Tommaso Pellis; Paolo Pelosi; Matt P Wise; Tobias Cronberg; David Erlinge; Hans Friberg Journal: Intensive Care Med Date: 2014-07-08 Impact factor: 17.440
Authors: Luuk C Otterspoor; Lokien X van Nunen; Tilaï T Rosalina; Marcel Van't Veer; Sjoerd Van Tuijl; Marco Stijnen; Marcel Cm Rutten; Frans N van de Vosse; Nico Hj Pijls Journal: Am J Transl Res Date: 2017-02-15 Impact factor: 4.060
Authors: Stefanie Marek-Iannucci; Amandine Thomas; Jean Hou; Annunziata Crupi; Jon Sin; David J Taylor; Lawrence S Czer; Fardad Esmailian; Robert M Mentzer; Allen M Andres; Roberta A Gottlieb Journal: Sci Rep Date: 2019-07-10 Impact factor: 4.379
Authors: Shahed Islam; James Hampton-Till; Shah MohdNazri; Noel Watson; Ellie Gudde; Tom Gudde; Paul A Kelly; Kare H Tang; John R Davies; Thomas R Keeble Journal: Ther Hypothermia Temp Manag Date: 2015-07-08 Impact factor: 1.286