{"id":"b284afaad472","type":"article","url":"https://hartvaat.nl/2016/05/01/therapeutische-hypothermie-bij-stemi-systematische-review-en-meta-analyse/","title":"Therapeutische hypothermie bij STEMI: systematische review en meta-analyse","title_en":"Therapeutic hypothermia in ST elevation myocardial infarction: a systematic review and meta-analysis of randomised control trials.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","bloeddrukbehandeling","farmaco-economie","fidelity","myocardinfarct","ouderen","select-trial","summit-trial","vrouwen"],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2015-308559","source_url":"https://doi.org/10.1136/heartjnl-2015-308559","authors":["Pedro A Villablanca","Gaurav Rao","David F Briceno","Marissa Lombardo","Harish Ramakrishna","Anna Bortnick","Mario García","Mark Menegus","Daniel Sims","Mohammed Makkiya","Farouk Mookadam"],"significance":6,"published":"2016-05-01","source_date":"2016-05-01","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/kleplijden/endocarditis-profylaxe/"],"congress":"","summary_en":"This systematic review and meta-analysis of randomized trials found that therapeutic hypothermia does not significantly reduce infarct size in STEMI patients, a negative result for this cardioprotective strategy despite promising preclinical data.","created":"2026-07-03T10:26:05Z","updated":"2026-07-03T13:25:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review en meta-analyse van gerandomiseerde trials naar het effect van therapeutische hypothermie op infarctgrootte en uitkomsten bij STEMI. Onderzoekt of koeling als adjuvante therapie bij reperfusie de myocardschade beperkt.","abstract_original":"OBJECTIVE: Our objective is to gain a better understanding of the efficacy and safety of therapeutic hypothermia (TH) in patients with acute ST elevation myocardial infarction (STEMI) through an analysis of randomised controlled trials (RCTs). BACKGROUND: Several RCTs have suggested a positive outcome with the use of TH in the prevention of myocardial injury in the setting of an acute STEMI. However, there are currently no clinical trials that have conclusively shown any significant benefit. METHODS: Electronic databases were used to identify RCTs of TH in the patient population with STEMI. The primary efficacy end point was major adverse cardiovascular event (MACE). Secondary efficacy end points included all-cause mortality, infarct size, new myocardial infarction and heart failure/pulmonary oedema (HF/PO). All-bleeding, ventricular arrhythmias and bradycardias were recorded as the safety end points. RESULTS: Six RCTs were included in this meta-analysis, enrolling a total of 819 patients. There was no significant benefit from TH in preventing MACE (OR, 01.04; 95% CI 0.37 to 2.89), all-cause mortality (OR, 1.48; 95% CI 0.68 to 3.19), new myocardial infarction (OR, 0.99; 95% CI 0.20 to 4.94), HF/PO (OR, 0.52; 95% CI 0.15 to 1.77) or infarct size (standard difference of the mean (SDM), -0.1; 95% CI -0.23 to 0.04). However, a significant reduction of infarct size was observed with TH utilisation in anterior wall myocardial infarction (SDM, -0.23; 95% CI -0.45 to -0.02). There was no significant difference seen for the safety end points all-bleeding (OR 1.32; 95% CI 0.77 to 2.24), ventricular arrhythmias (OR, 0.85; 95% CI 0.54 to 1.36) or bradycardias (OR, 1.16; 95% CI 0.74 to 1.83). CONCLUSIONS: Although TH appears to be safe in patients with STEMI, meta-analysis of published RCTs indicates that benefit is limited to reduction of infarct size in patients with anterior wall involvement with no demonstrable effect on all-cause mortality, recurrent myocardial infarction or HF/PO."}