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Therapeutic Hypothermia for the Treatment of Acute Myocardial Infarction–Combined Analysis of the RAPID MI-ICE and the CHILL-MI Trials

2015; Mary Ann Liebert, Inc.; Volume: 5; Issue: 2 Linguagem: Inglês

10.1089/ther.2015.0009

2153-7933

David Erlinge, Matthias Götberg, Marko Noč, Iréne Lang, Michael Hölzer, Peter Clemmensen, Ulf Jensen, Bernhard Metzler, Stefan James, Hans Erik Bøtker, Elmir Ömerovic, Sasha Koul, Henrik Engblom, Marcus Carlsson, Håkan Arheden, Ollie Östlund, Lars Wallentin, Bradley Klos, Jan Harnek, Göran Olivecrona,

Cardiac Imaging and Diagnostics

In the randomized rapid intravascular cooling in myocardial infarction as adjunctive to percutaneous coronary intervention (RAPID MI-ICE) and rapid endovascular catheter core cooling combined with cold saline as an adjunct to percutaneous coronary intervention for the treatment of acute myocardial infarction CHILL-MI studies, hypothermia was rapidly induced in conscious patients with ST-elevation myocardial infarction (STEMI) by a combination of cold saline and endovascular cooling. Twenty patients in RAPID MI-ICE and 120 in CHILL-MI with large STEMIs, scheduled for primary percutaneous coronary intervention (PCI) within 30% of the left ventricle) exhibited significantly reduced IS/MaR in the hypothermia group (40.5, 27.0–57.6 vs. 55.1, 41.1–64.4, median, IQR; hypothermia n=42 vs. control n=37, p=0.03), while patients with MaR<30% did not show effect of hypothermia (35.8, 28.3–57.5 vs. 38.4, 27.4–59.7, median, IQR; hypothermia n=15 vs. control n=19, p=0.50). The prespecified pooled analysis of RAPID MI-ICE and CHILL-MI indicates a reduction of myocardial IS and reduction in heart failure by 1–3 hours with endovascular cooling in association with primary PCI of acute STEMI predominantly in patients with large area of myocardium at risk. (ClinicalTrials.gov id NCT00417638 and NCT01379261).