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

Götberg, Matthias LU ; Olivecrona, Göran LU ; Koul, Sasha LU ; Carlsson, Marcus LU ; Engblom, Henrik LU ; Ugander, Martin LU ; vanderPals, Jesper LU ; Algotsson, Lars LU ; Arheden, Håkan LU and Erlinge, David LU (2010) In Circulation. Cardiovascular Interventions 3. p.400-407
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Circulation. Cardiovascular Interventions
volume
3
pages
400 - 407
publisher
American Heart Association
external identifiers
  • wos:000283160500007
  • pmid:20736446
  • scopus:78650120763
ISSN
1941-7632
DOI
10.1161/CIRCINTERVENTIONS.110.957902
language
English
LU publication?
yes
id
68e0fb14-9c35-429a-908b-d5b17ca6e292 (old id 1665027)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20736446?dopt=Abstract
date added to LUP
2010-09-03 11:31:41
date last changed
2018-11-21 20:50:19
@article{68e0fb14-9c35-429a-908b-d5b17ca6e292,
  abstract     = {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 &lt;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.},
  author       = {Götberg, Matthias and Olivecrona, Göran and Koul, Sasha and Carlsson, Marcus and Engblom, Henrik and Ugander, Martin and vanderPals, Jesper and Algotsson, Lars and Arheden, Håkan and Erlinge, David},
  issn         = {1941-7632},
  language     = {eng},
  pages        = {400--407},
  publisher    = {American Heart Association},
  series       = {Circulation. Cardiovascular Interventions},
  title        = {A Pilot Study of Rapid Cooling by Cold Saline and Endovascular Cooling Before Reperfusion in Patients With ST-Elevation Myocardial Infarction.},
  url          = {http://dx.doi.org/10.1161/CIRCINTERVENTIONS.110.957902},
  volume       = {3},
  year         = {2010},
}