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Disclosure statement: The study was partly sponsored by an unrestricted research grant
from Innercool Therapies, a fully owned subsidiary of Philips Healthcare.
Hypothermia in Acute MI
1Duncker et al. 1996 (Am J Physiol 270, H1189),2 Dae MW, et al. 2002 (Am J Physiol Heart Circ Physiol 282:H1584-
91).,3 Götberg M et al . BMC Cardiovasc Disord. 2008, 8:7, 4 Grines CL et al. TCT 2004, 5 O'Neill WW et al. TCT 2004
Hypothermia in Acute MI
•20 Patients
•Anterior or large Inferior STEMI
•<6 hrs from onset of symtoms
•Rapid infusion 1-2 liters 4°C Saline solution.
•Endovascular cooling with Philips InnerCool endovascular
system with Accutrol catheter starting before angiogram
and continuing 3 h after PCI
•Cardiac MRI day 4±2, infarct size/ myocardium at risk (T2
stir)
Endovascular
catheter placement
Buspirone Temp
Meperidine iv
Cold saline 1-2 l
Feasibility
ECG
Patient Info Patient prep,
Randomization catheterization Angiography, PCI
3 min prolonged
procedure before
37 reperfusion
T e m p e ra tu re (C )
36 Hypothermia
Temp: 34.7 ± 0.3°C at
Control
35 reperfusion
Successful revascularization 9 9 NS
TIMI 3 flow post PCI 9 9 NS
Thrombectomy 8 7 NS
Abciximab 6 6 NS
Bivalirudin 3 3 NS
2/20 patients, One from each group was excluded for technical reasons
Safety
NT-proBNP (ng/l)
Heart failure 0 3 1500
VT/VF 0 2
Stroke 0 0 1000
Infection 3 0
Major bleeding 0 0 500
Bradycardia 0 0
0
Hypothermia Control
Efficacy
Reduction of infarct size Reduction in Troponin
Final Infarct Size/ Myocardium at Risk (Peak value)
Δ = 38% Δ = 43%
p = 0·04 p = 0·01
Infarct size / Myocardium at risk
80 8
70 7
Troponin T (ug/l)
60 6
50 5
40 4
30 3
20 2
10 1
0 0
Hypothermia Control Hypothermia Control
Speckled infarction in pig
Wavefront phenomenon Hypothermia Normothermia
(Jennings)