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Safety of Selective Intracoronary Hypothermia During Primary Percutaneous Coronary Intervention in Patients With Anterior STEMI

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  • Mohamed El Farissi
  • Richard Good
  • Thomas Engstrøm
  • Keith G Oldroyd
  • Grigoris V Karamasis
  • Pieter J Vlaar
  • Jacob T Lønborg
  • Koen Teeuwen
  • Thomas R Keeble
  • Kenneth Mangion
  • Bernard De Bruyne
  • Ole Fröbert
  • Annemiek De Vos
  • Bastiaan Zwart
  • Roel J R Snijder
  • Guus R G Brueren
  • Pieter-Jan Palmers
  • Inge F Wijnbergen
  • Colin Berry
  • Pim A L Tonino
  • Luuk C Otterspoor
  • Nico H J Pijls
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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.

Original languageEnglish
JournalJACC: Cardiovascular Interventions
Volume14
Issue number18
Pages (from-to)2047-2055
Number of pages9
ISSN1936-8798
DOIs
Publication statusPublished - 27 Sep 2021

Bibliographical note

Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

    Research areas

  • Humans, Hypothermia, Percutaneous Coronary Intervention/adverse effects, ST Elevation Myocardial Infarction/diagnostic imaging, Time Factors, Treatment Outcome

ID: 71706030