Safety of Selective Intracoronary Hypotheria during Primary Percutaneous Coronary Intervention in Patients with Anterior St-Elevation Myocardial Infarction

El Farissi, Mohamed and Good, Richard and Engstrøm, Thomas and Oldroyd, Keith G. and Karamasis, Grigoris V. and Vlaar, Pieter J. and Lønborg, Jacob T. and Teeuwen, Koen and Keeble, Thomas R. and Mangion, Kenneth and De Bruyne, Bernard and Fröbert, Ole and De Vos, Annemiek and Zwart, Bastian and Snijder, Roel J. R. and Brueren, Guus R. G. and Palmers, Pieter-Jan and Wijnbergen, Inge F. and Berry, Colin and Tonino, Pim A. L. and Otterspoor, Luuk C. and Pijls, Nico H. J. (2021) Safety of Selective Intracoronary Hypotheria during Primary Percutaneous Coronary Intervention in Patients with Anterior St-Elevation Myocardial Infarction. JACC: Cardiovascular Interventions, 14 (18). pp. 2047-2055. ISSN 1876-7605

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Objectives- The aim of this study was to determine the safety of selective intracoronary hypothermia during primary percutaneous coronary intervention (PPCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI). Background- Selective intracoronary hypothermia is a novel treatment designed to reduce myocardial reperfusion injury and is currently being investigated in the ongoing randomized controlled EURO-ICE (European Intracoronary Cooling Evaluation in Patients With ST-Elevation Myocardial Infarction) trial (NCT03447834). Data on the safety of such a procedure during PPCI are still limited. Methods- The first 50 patients with anterior STEMI treated with selective intracoronary hypothermia during PPCI were included in this analysis and compared for safety with the first 50 patients randomized to the control group undergoing standard PPCI. In-hospital mortality, occurrence of rhythm or conduction disturbances, stent thrombosis, onset of heart failure during the procedure, and subsequent hospital admission were assessed. Results- In-hospital mortality was 0%. One patient in both groups developed cardiogenic shock. Atrial fibrillation occurred in 0 and 3 patients (P = 0.24), and ventricular fibrillation occurred in 5 and 3 patients (P = 0.72) in the intracoronary hypothermia group and control group, respectively. Stent thrombosis occurred in 2 patients in the intracoronary hypothermia group; 1 instance was intraprocedural, and the other occurred following interruption of dual-antiplatelet therapy consequent to an intracranial hemorrhage 6 days after enrollment. No stent thrombosis was observed in the control group (P = 0.50). Conclusions- Selective intracoronary hypothermia during PPCI in patients with anterior STEMI can be implemented within the routine of PPCI and seems to be safe. The final safety results will be reported at the end of the trial.

Item Type: Journal Article
Keywords: STEMI, selective intracoronary hypothermia, myocardial reperfusion injury, infarct size, procedural safety
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Ian Walker
Date Deposited: 18 Jun 2021 10:49
Last Modified: 24 Sep 2021 15:00

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