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A randomised trial ...
A randomised trial of selective intracoronary hypothermia during primary PCI
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- El Farissi, Mohamed (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Pijls, Nico H. J. (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Good, Richard (author)
- Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
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- Engström, Thomas (author)
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
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- Keeble, Thomas R. (author)
- Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom
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- Beleslin, Branko (author)
- Department of Cardiology, Clinical Center of Serbia, Belgrade, Serbia
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- De Bruyne, Bernard (author)
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
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- Fröbert, Ole, 1964- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
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- Erlinge, David (author)
- Department of Cardiology, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden
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- Teeuwen, Koen (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Eerdekens, Rob (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Demandt, Jesse P. A. (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Mangion, Kenneth (author)
- Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
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- Lonborg, Jakob (author)
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
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- Setz-Pels, Wikke (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Karamasis, Grigoris (author)
- Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom
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- Wijnbergen, Inge (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Vlaar, Pieter Jan (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- de Vos, Annemiek (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Brueren, Guus R. (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Oldroyd, Keith (author)
- Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
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- Berry, Colin (author)
- Department of Cardiology, Golden Jubilee National Hospital, Clydebank, United Kingdom
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- Tonino, Pim A. L. (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Van't Veer, Marcel (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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- Otterspoor, Luuk C. (author)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
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(creator_code:org_t)
- European Society of Cardiology, 2024
- 2024
- English.
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In: EuroIntervention. - : European Society of Cardiology. - 1774-024X .- 1969-6213. ; 20:12
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.4...
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Abstract
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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).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- cooling
- hypothermia
- infarct size
- MVO
- myocardial reperfusion injury
- STEMI
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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El Farissi, Moha ...
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Pijls, Nico H. J ...
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Good, Richard
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Engström, Thomas
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Keeble, Thomas R ...
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Beleslin, Branko
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show more...
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De Bruyne, Berna ...
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Fröbert, Ole, 19 ...
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Erlinge, David
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Teeuwen, Koen
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Eerdekens, Rob
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Demandt, Jesse P ...
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Mangion, Kenneth
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Lonborg, Jakob
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Setz-Pels, Wikke
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Karamasis, Grigo ...
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Wijnbergen, Inge
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Vlaar, Pieter Ja ...
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de Vos, Annemiek
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Brueren, Guus R.
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Oldroyd, Keith
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Berry, Colin
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Tonino, Pim A. L ...
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Van't Veer, Marc ...
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Otterspoor, Luuk ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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EuroIntervention
- By the university
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Örebro University