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Sökning: WFRF:(Demandt J) > (2024) > A randomised trial ...

A randomised trial of selective intracoronary hypothermia during primary PCI

El Farissi, Mohamed (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Pijls, Nico H. J. (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Good, Richard (författare)
Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
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Engström, Thomas (författare)
Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
Keeble, Thomas R. (författare)
Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom
Beleslin, Branko (författare)
Department of Cardiology, Clinical Center of Serbia, Belgrade, Serbia
De Bruyne, Bernard (författare)
Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
Fröbert, Ole, 1964- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
Erlinge, David (författare)
Department of Cardiology, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden
Teeuwen, Koen (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Eerdekens, Rob (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Demandt, Jesse P. A. (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Mangion, Kenneth (författare)
Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
Lonborg, Jakob (författare)
Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
Setz-Pels, Wikke (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Karamasis, Grigoris (författare)
Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom
Wijnbergen, Inge (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Vlaar, Pieter Jan (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
de Vos, Annemiek (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Brueren, Guus R. (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Oldroyd, Keith (författare)
Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
Berry, Colin (författare)
Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
Tonino, Pim A. L. (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Van't Veer, Marcel (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
Otterspoor, Luuk C. (författare)
Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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 (creator_code:org_t)
European Society of Cardiology, 2024
2024
Engelska.
Ingår i: EuroIntervention. - : European Society of Cardiology. - 1774-024X .- 1969-6213. ; 20:12
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.4...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND: While experimental data suggest that selective intracoronary hypothermia decreases infarct size, studies in patients with ST-elevation myocardial infarction (STEMI) are lacking.AIMS: We investigated the efficacy of selective intracoronary hypothermia during primary percutaneous coronary intervention (PCI) to decrease infarct size in patients with STEMI.METHODS: In this multicentre randomised controlled trial, 200 patients with large anterior wall STEMI were randomised 1:1 to selective intracoronary hypothermia during primary PCI or primary PCI alone. Using an over-the-wire balloon catheter for infusion of cold saline and a pressure-temperature wire to monitor the intracoronary temperature, the anterior myocardium distal to the occlusion was selectively cooled to 30-33°C for 7-10 minutes before reperfusion (occlusion phase), immediately followed by 10 minutes of cooling after reperfusion (reperfusion phase). The primary endpoint was infarct size as a percentage of left ventricular mass on cardiovascular magnetic resonance imaging after 3 months.RESULTS: Selective intracoronary hypothermia was performed in 94/100 patients randomised to cooling. Distal coronary temperature decreased by 6°C within 43 seconds (interquartile range [IQR] 18-113). The median duration of the occlusion phase and reperfusion phase were 8.2 minutes (IQR 7.2-9.0) and 9.1 minutes (IQR 8.2-10.0), respectively. The infarct size at 3 months was 23.1±12.5% in the selective intracoronary hypothermia group and 21.6±12.2% in the primary PCI alone group (p=0.43). The left ventricular ejection fraction at 3 months in each group were 49.1±10.2% and 50.1±10.4%, respectively (p=0.53).CONCLUSIONS: Selective intracoronary hypothermia during primary PCI in patients with anterior wall STEMI was feasible and safe but did not decrease infarct size compared with standard primary PCI. (ClinicalTrials.gov: NCT03447834).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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