Journal ArticleDOI
Therapeutic Hypothermia for the Treatment of Acute Myocardial Infarction - Combined analysis of the RAPID MI- ICE and the CHILL-MI trials
David Erlinge,Matthias Götberg,Marko Noc,Irene Lang,Michael Holzer,Peter Clemmensen,Ulf Jensen,Bernhard Metzler,Stefan James,Hans Erik Bøtker,Elmir Omerovic,Sasha Koul,Henrik Engblom,Marcus Carlsson,Håkan Arheden,Ollie Östlund,Lars Wallentin,Brad Klos,Jan Harnek,Göran K. Olivecrona +19 more
TLDR
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 mycardium at risk.Abstract:
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).read more
Citations
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Journal ArticleDOI
Ischaemic conditioning and reperfusion injury
TL;DR: A number of cardioprotective therapies have shown promising results in reducing infarct size and improving clinical outcomes in patients with ischaemic heart disease.
Journal ArticleDOI
Critical Issues for the Translation of Cardioprotection.
TL;DR: Experimental studies addressing long-term effects of adjunct cardioprotection beyond infarct size reduction, that is, on repair, remodeling, and mortality, are lacking and future trials must focus on interventions/agents with robust preclinical evidence, have solid phase II dosing and timing data, and recruit patients who have truly a chance to benefit from adjunct cardiprotection.
Journal ArticleDOI
Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest – an analysis of the TTM trial data
Guy Glover,Guy Glover,Richard M. Thomas,George Vamvakas,Nawaf Al-Subaie,Jules Cranshaw,Andrew Walden,Matt P. Wise,Marlies Ostermann,Emma Thomas-Jones,Tobias Cronberg,David Erlinge,Yvan Gasche,Christian Hassager,Janneke Horn,Jesper Kjaergaard,Michael A. Kuiper,Tommaso Pellis,Pascal Stammet,Michael Wanscher,Jørn Wetterslev,Hans Friberg,Niklas Nielsen +22 more
TL;DR: Intravascular and surfacecooling was equally effective during induction of mild hypothermia, however, surface cooling was associated with less precision during the maintenance phase.
Journal ArticleDOI
COOL AMI EU pilot trial: a multicentre, prospective, randomised controlled trial to assess cooling as an adjunctive therapy to percutaneous intervention in patients with acute myocardial infarction
Marko Noc,David Erlinge,Aleksandar N. Neskovic,Srdjan Kafedzic,Béla Merkely,Endre Zima,Misa Fister,Milovan Petrovic,Milenko Cankovic,Gábor Veress,Peep Laanmets,Teele Pern,Vladan Vukcevic,Vladimir Dedovic,Beata Średniawa,Andrzej Świątkowski,Thomas R. Keeble,John R. Davies,Alexandra-Maria Warenits,Göran K. Olivecrona,Jan Z. Peruga,Michal Ciszewski,Iván Horváth,István Édes,Gergely G. Nagy,Daniel Aradi,Michael Holzer +26 more
TL;DR: A statistically non-significant numerical 7.1% absolute and 30% relative reduction in infarct size warrants a pivotal trial powered for efficacy in patients with anterior ST-elevation myocardial infarction without cardiac arrest.
Journal ArticleDOI
Therapeutic Hypothermia and Stent Thrombosis: A Nationwide Analysis.
Neeraj Shah,Rahul Chaudhary,Kathan Mehta,Vratika Agarwal,Jalaj Garg,Ronald S. Freudenberger,Larry E Jacobs Md,David A. Cox,Karl B. Kern,Nainesh Patel +9 more
TL;DR: TH does not increase the incidence of stent thrombosis after primary PCI in patients with acute myocardial infarction presenting as CA, and "real-world" data supported the hypothesis that therapeutic hypothermia (TH) led to increased rates of stenting.
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