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A pooled analysis of the effect of endovascular cooling on infarct size in patients with ST-elevation myocardial infarction.

Erlinge, David LU ; Götberg, Matthias LU ; Grines, Cindy; Dixon, Simon; Baran, Kenneth; Kandzari, David and Olivecrona, Göran LU (2013) In EuroIntervention 8(12). p.1435-1440
Abstract
Aims: Prior evaluations of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have suggested variability in treatment effect related to core temperature at the time of reperfusion, to infarct location and time from symptom onset to reperfusion. Recent results from a randomised feasibility study suggest rapid induction of hypothermia in primary PCI results in a significant reduction in infarct size (IS). Methods and results: Outcomes from two randomised trials of hypothermia in primary PCI were pooled to examine IS as a percentage of left ventricular myocardium assessed by SPECT or magnetic resonance imaging. Compared with controls (n=103), hypothermia (n=94) was associated... (More)
Aims: Prior evaluations of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have suggested variability in treatment effect related to core temperature at the time of reperfusion, to infarct location and time from symptom onset to reperfusion. Recent results from a randomised feasibility study suggest rapid induction of hypothermia in primary PCI results in a significant reduction in infarct size (IS). Methods and results: Outcomes from two randomised trials of hypothermia in primary PCI were pooled to examine IS as a percentage of left ventricular myocardium assessed by SPECT or magnetic resonance imaging. Compared with controls (n=103), hypothermia (n=94) was associated with a significant 24% relative reduction (RR) in IS (10.7±1.3% vs. 14.1±1.6%, mean±SEM, p=0.049). Among hypothermia-treated patients for whom core temperature <35 C° was achieved before reperfusion, IS was reduced by 37% (8.8±1.7% vs. 14.1±1.6%, p=0.01), a benefit observed for both anterior (14.9±2.9% vs. 22.2±2.7%, RR 33%; p=0.03) and inferior infarcts (4.5±1.4% vs. 7.7±1.3%, RR 42%; p=0.04). Conclusions: In a pooled analysis of randomised trials evaluating adjunctive hypothermia in primary PCI, achievement of core body temperature <35°C before reperfusion may reduce infarct size with a similar efficacy for both anterior and inferior MI. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
EuroIntervention
volume
8
issue
12
pages
1435 - 1440
publisher
Société Europa Edition
external identifiers
  • wos:000318751700014
  • pmid:23164721
  • scopus:84878320736
ISSN
1969-6213
DOI
10.4244/EIJV8I12A217
language
English
LU publication?
yes
id
6ebdfff6-dd96-4d94-9a21-a25916e5d9ba (old id 3218814)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23164721?dopt=Abstract
date added to LUP
2012-12-03 20:04:36
date last changed
2019-09-11 01:12:15
@article{6ebdfff6-dd96-4d94-9a21-a25916e5d9ba,
  abstract     = {Aims: Prior evaluations of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have suggested variability in treatment effect related to core temperature at the time of reperfusion, to infarct location and time from symptom onset to reperfusion. Recent results from a randomised feasibility study suggest rapid induction of hypothermia in primary PCI results in a significant reduction in infarct size (IS). Methods and results: Outcomes from two randomised trials of hypothermia in primary PCI were pooled to examine IS as a percentage of left ventricular myocardium assessed by SPECT or magnetic resonance imaging. Compared with controls (n=103), hypothermia (n=94) was associated with a significant 24% relative reduction (RR) in IS (10.7±1.3% vs. 14.1±1.6%, mean±SEM, p=0.049). Among hypothermia-treated patients for whom core temperature &lt;35 C° was achieved before reperfusion, IS was reduced by 37% (8.8±1.7% vs. 14.1±1.6%, p=0.01), a benefit observed for both anterior (14.9±2.9% vs. 22.2±2.7%, RR 33%; p=0.03) and inferior infarcts (4.5±1.4% vs. 7.7±1.3%, RR 42%; p=0.04). Conclusions: In a pooled analysis of randomised trials evaluating adjunctive hypothermia in primary PCI, achievement of core body temperature &lt;35°C before reperfusion may reduce infarct size with a similar efficacy for both anterior and inferior MI.},
  author       = {Erlinge, David and Götberg, Matthias and Grines, Cindy and Dixon, Simon and Baran, Kenneth and Kandzari, David and Olivecrona, Göran},
  issn         = {1969-6213},
  language     = {eng},
  number       = {12},
  pages        = {1435--1440},
  publisher    = {Société Europa Edition},
  series       = {EuroIntervention},
  title        = {A pooled analysis of the effect of endovascular cooling on infarct size in patients with ST-elevation myocardial infarction.},
  url          = {http://dx.doi.org/10.4244/EIJV8I12A217},
  volume       = {8},
  year         = {2013},
}