Therapeutic hypothermia not beneficial in awake patients with ST-elevation myocardial infarction

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Results from several randomized control trials on the potential benefit of therapeutic hypothermia (TH) in patients with acute ST-elevation myocardial infarction (STEMI) are contradictory.

Researchers analyzed 10 RCTs, including 706 patients, to compare the efficacy and safety of adjunctive TH with standard percutaneous coronary intervention (PCI) in awake patients with STEMI.

Therapeutic hypothermia was not associated with a statistically significant improvement in the infarct size or in the microvascular obstruction compared to standard PCI. Major adverse cardiovascular events were comparable between the groups, but TH was associated with an increased risk of infection and prolonged door-to-balloon time.

There was a trend toward increased incidence of stent thrombosis and paroxysmal atrial fibrillation in the TH group.

Mhanna M, Ranabothu M, Al-Abdouh A, et al. Hypothermia as an adjunctive therapy to percutaneous intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized control trials. Cardiovasc Revasc Med. 2022;S1553-8389(22)00773-4. doi: 10.1016/j.carrev.2022.09.005. Epub ahead of print. PMID: 36115819.