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Updated: Aug 28, 2025

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model
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In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model

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Hypothermia as an Adjunctive Therapy to Percutaneous Intervention in ST-Elevation Myocardial Infarction: A Systematic

Mohammed Mhanna1, Meghana Ranabothu2, Ahmad Al-Abdouh3

  • 1Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|September 17, 2022
PubMed

Insights

Therapeutic hypothermia (TH) did not improve infarct size or outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). This meta-analysis found TH offers no benefit and may increase infection risk and delay treatment.

Area of Science:

  • Cardiology
  • Critical Care Medicine

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical condition where therapeutic hypothermia (TH) has been investigated for potential benefits.
  • Previous randomized control trials (RCTs) on adjunctive TH in STEMI have yielded contradictory results, necessitating further analysis.

Approach:

  • A comprehensive meta-analysis was conducted on 10 RCTs involving 706 patients with STEMI undergoing percutaneous coronary intervention (PCI).
  • Primary outcomes assessed were infarct size (IS) and microvascular obstruction (MVO) via cardiac imaging.
  • Secondary outcomes included major adverse cardiovascular events (MACE), procedural complications, and door-to-balloon time.

Key Points:

  • Therapeutic hypothermia (TH) did not significantly reduce infarct size (IS) or microvascular obstruction (MVO) compared to standard PCI in STEMI patients.
  • Major adverse cardiovascular events (MACE) were similar between the TH and standard PCI groups.
  • The TH approach was linked to an increased risk of infection and prolonged door-to-balloon times, with trends toward more stent thrombosis and atrial fibrillation.

Conclusions:

  • Current meta-analysis indicates therapeutic hypothermia (TH) provides no significant benefit for awake STEMI patients treated with PCI.
  • The safety profile of TH is questionable, associated with potential care delays and increased infection risk.
  • Larger-scale RCTs are required to definitively ascertain the efficacy and safety of TH in this patient population.
Abstract

Keywords:
Acute coronary syndromeCoolingHypothermiaInfarction sizeLeft ventricle ejection fractionPercutaneous coronary interventionSTEMI

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