# Prehospitale hypothermie bij STEMI: gerandomiseerde trial

*geplaatst 2019-04-01 · Algemeen · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2018-313705 · https://hartvaat.nl/2019/04/01/prehospitale-hypothermie-bij-stemi-gerandomiseerde-trial/*

Gerandomiseerde trial die prehospitale initiatie van hypothermie onderzocht bij STEMI voor beperking van infarctgrootte.

## English: Out-of-hospital initiation of hypothermia in ST-segment elevation myocardial infarction: a randomised trial.

This randomized trial tested prehospital hypothermia initiation in awake STEMI patients for infarct size limitation, evaluating the feasibility of cooling before hospital arrival.

## Abstract (original, from the publication)

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.

Auteurs: Christoph Testori, Dietrich Beitzke, Andreas Mangold, Fritz Sterz, Christian Loewe, Christoph Weiser, Thomas Scherz, Harald Herkner, Irene Lang

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2018-313705. Bijgewerkt 2026-07-03T13:27:03Z. 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.