A Pilot Study of Rapid Cooling by Cold Saline and Endovascular Cooling Before Reperfusion in Patients With ST-Elevation Myocardial Infarction.

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T1 - A Pilot Study of Rapid Cooling by Cold Saline and Endovascular Cooling Before Reperfusion in Patients With ST-Elevation Myocardial Infarction.

AU - Götberg, Matthias

AU - Olivecrona, Göran

AU - Koul, Sasha

AU - Carlsson, Marcus

AU - Engblom, Henrik

AU - Ugander, Martin

AU - vanderPals, Jesper

AU - Algotsson, Lars

AU - Arheden, Håkan

AU - Erlinge, David

PY - 2010

Y1 - 2010

N2 - Background-Experimental studies have shown that induction of hypothermia before reperfusion of acute coronary occlusion reduces infarct size. Previous clinical studies, however, have not been able to show this effect, which is believed to be mainly because therapeutic temperature was not reached before reperfusion in the majority of the patients. We aimed to evaluate the safety and feasibility of rapidly induced hypothermia by infusion of cold saline and endovascular cooling catheter before reperfusion in patients with acute myocardial infarction. METHODS AND RESULTS: =0.12). Despite similar duration of ischemia (174+/-51 minutes versus 174+/-62 minutes, hypothermia versus control, P=1.00), infarct size normalized to myocardium at risk was reduced by 38% in the hypothermia group compared with the control group (29.8+/-12.6% versus 48.0+/-21.6%, P=0.041). This was supported by a significant decrease in both peak and cumulative release of Troponin T in the hypothermia group (P=0.01 and P=0.03, respectively). Conclusions-The protocol demonstrates the ability to reach a core body temperature of <35 degrees C before reperfusion in all patients without delaying primary percutaneous coronary intervention and that combination hypothermia as an adjunct therapy in acute myocardial infarction may reduce infarct size at 3 days as measured by MRI. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT00417638.

AB - Background-Experimental studies have shown that induction of hypothermia before reperfusion of acute coronary occlusion reduces infarct size. Previous clinical studies, however, have not been able to show this effect, which is believed to be mainly because therapeutic temperature was not reached before reperfusion in the majority of the patients. We aimed to evaluate the safety and feasibility of rapidly induced hypothermia by infusion of cold saline and endovascular cooling catheter before reperfusion in patients with acute myocardial infarction. METHODS AND RESULTS: =0.12). Despite similar duration of ischemia (174+/-51 minutes versus 174+/-62 minutes, hypothermia versus control, P=1.00), infarct size normalized to myocardium at risk was reduced by 38% in the hypothermia group compared with the control group (29.8+/-12.6% versus 48.0+/-21.6%, P=0.041). This was supported by a significant decrease in both peak and cumulative release of Troponin T in the hypothermia group (P=0.01 and P=0.03, respectively). Conclusions-The protocol demonstrates the ability to reach a core body temperature of <35 degrees C before reperfusion in all patients without delaying primary percutaneous coronary intervention and that combination hypothermia as an adjunct therapy in acute myocardial infarction may reduce infarct size at 3 days as measured by MRI. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT00417638.

U2 - 10.1161/CIRCINTERVENTIONS.110.957902

DO - 10.1161/CIRCINTERVENTIONS.110.957902

M3 - Article

VL - 3

SP - 400

EP - 407

JO - Circulation: Cardiovascular Interventions

JF - Circulation: Cardiovascular Interventions

SN - 1941-7632

ER -