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

被引：25

作者：

El Farissi, Mohamed ^{[1
]}

Good, Richard ^{[2
]}

Engstrom, Thomas ^{[3
]}

Oldroyd, Keith G. ^{[2
]}

Karamasais, Grigoris, V ^{[4
,5
]}

Vlaar, Pieter J. ^{[1
]}

Lonborg, Jacob T.

Teeuwen, Koen ^{[1
]}

Keeble, Thomas R. ^{[4
,5
]}

Mangion, Kenneth ^{[2
]}

De Bruyne, Bernard ^{[6
]}

Frobert, Ole ^{[7
]}

De Vos, Annemiek ^{[1
]}

Zwart, Bastiaan ^{[1
]}

Snijder, Roel J. R. ^{[1
]}

Brueren, Guus R. G. ^{[1
]}

Palmers, Pieter-Jan ^{[1
]}

Wijnbergen, Inge F. ^{[1
]}

Berry, Colin ^{[2
,8
]}

Tonino, Pim A. L. ^{[1
]}

Otterspoor, Luuk C. ^{[1
]}

Pijls, Nico H. J. ^{[1
]}

机构：

[1] Catharina Hosp, Dept Cardiol, Michelangelolaan 2, NL-5623 EJ Eindhoven, Netherlands

[2] Golden Jubilee Natl Hosp, Dept Cardiol, Glasgow, Lanark, Scotland

[3] Rigshosp, Dept Cardiol, Copenhagen, Denmark

[4] Essex Cardiothorac Ctr, Dept Cardiol, Basildon, England

[5] Anglia Ruskin Sch Med, Chelmsford, Essex, England

[6] OLV Clin, Cardiovasc Ctr Aalst, Aalst, Belgium

[7] Orebro Univ, Fac Hlth, Dept Cardiol, Orebro, Sweden

[8] Univ Glasgow, British Heart Fdn, Glasgow Cardiovasc Res Ctr, Glasgow, Lanark, Scotland

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2021年 / 14卷 / 18期

基金：

英国医学研究理事会;

关键词：

  infarct size; myocardial reperfusion injury; procedural safety; selective intracoronary hypothermia; STEMI; ACUTE MYOCARDIAL-INFARCTION;

D O I：

10.1016/j.jcin.2021.06.009

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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. (J Am Coll Cardiol Intv 2021;14:2047-2055) (c) 2021 by the American College of Cardiology Foundation.

引用

页码：2047 / 2055

页数：9

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