{"id":"7cf66131c7d2","type":"article","url":"https://hartvaat.nl/2019/04/01/prehospitale-hypothermie-bij-stemi-gerandomiseerde-trial/","title":"Prehospitale hypothermie bij STEMI: gerandomiseerde trial","title_en":"Out-of-hospital initiation of hypothermia in ST-segment elevation myocardial infarction: a randomised trial.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2018-313705","source_url":"https://doi.org/10.1136/heartjnl-2018-313705","authors":["Christoph Testori","Dietrich Beitzke","Andreas Mangold","Fritz Sterz","Christian Loewe","Christoph Weiser","Thomas Scherz","Harald Herkner","Irene Lang"],"significance":5,"published":"2019-04-01","source_date":"2019-04-01","image":"","kennis":[],"congress":"","summary_en":"This randomized trial tested prehospital hypothermia initiation in awake STEMI patients for infarct size limitation, evaluating the feasibility of cooling before hospital arrival.","created":"2026-07-03T10:27:50Z","updated":"2026-07-03T13:27:03Z","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":"Gerandomiseerde trial die prehospitale initiatie van hypothermie onderzocht bij STEMI voor beperking van infarctgrootte.","abstract_original":"OBJECTIVE: To evaluate the effect of prereperfusion hypothermia initiated in the out-of-hospital setting in awake patients with ST-segment elevation myocardial infarction (STEMI) on myocardial salvage measured by cardiac MRI (CMR). METHODS: Hypothermia was initiated within 6 hours of symptom onset by the emergency medical service with surface cooling pads and cold saline, and continued in the cath lab with endovascular cooling (target temperature: ≤35°C at time of reperfusion). Myocardial salvage index (using CMR) was compared in a randomised, controlled, open-label, endpoint blinded trial to a not-cooled group of patients at day 4±2 after the event. RESULTS: After postrandomisation exclusion of 19 patients a total of 101 patients were included in the intention-to-treat analysis (control group: n=54; hypothermia group: n=47). Target temperature was reached in 38/47 patients (81%) in the intervention group. Study-related interventions resulted in a delay in time from first medical contact to reperfusion of 14 min (control group 89±24 min; hypothermia group 103±21 min; p<0.01). Myocardial salvage index was 0.37 (±0.26) in the control group and 0.43 (±0.27) in the hypothermia group (p=0.27). No differences in cardiac biomarkers or clinical outcomes were found. In a CMR follow-up 6 months after the initial event no significant differences were detected. CONCLUSION: Out-of-hospital induced therapeutic hypothermia as an adjunct to primary percutaneous coronary intervention did not improve myocardial salvage in patients with STEMI. TRIAL REGISTRATION NUMBER: NCT01777750."}