PMID- 26864673
OWN - NLM
STAT- MEDLINE
DCOM- 20160822
LR  - 20181202
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 102
IP  - 9
DP  - 2016 May
TI  - Therapeutic hypothermia in ST elevation myocardial infarction: a systematic 
      review and meta-analysis of randomised control trials.
PG  - 712-9
LID - 10.1136/heartjnl-2015-308559 [doi]
AB  - 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.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/
FAU - Villablanca, Pedro A
AU  - Villablanca PA
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Rao, Gaurav
AU  - Rao G
AD  - Department of Internal Medicine, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Briceno, David F
AU  - Briceno DF
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Lombardo, Marissa
AU  - Lombardo M
AD  - Department of Internal Medicine, New York-Presbyterian Hospital/Weill Cornell 
      Medical College, New York, New York, USA.
FAU - Ramakrishna, Harish
AU  - Ramakrishna H
AD  - Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic College of 
      Medicine, Scottsdale, Arizona, USA.
FAU - Bortnick, Anna
AU  - Bortnick A
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Garcia, Mario
AU  - Garcia M
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Menegus, Mark
AU  - Menegus M
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Sims, Daniel
AU  - Sims D
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Makkiya, Mohammed
AU  - Makkiya M
AD  - Department of Internal Medicine, Montefiore Medical Center/Albert Einstein 
      College of Medicine, New York, New York, USA.
FAU - Mookadam, Farouk
AU  - Mookadam F
AD  - Cardiovascular Division, Mayo Clinic College of Medicine, Scottsdale, Arizona, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20160210
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Nat Rev Cardiol. 2016 Apr;13(4):183. PMID: 26911332
CIN - J Thorac Dis. 2016 Aug;8(8):E796-8. PMID: 27620366
MH  - Arrhythmias, Cardiac/etiology
MH  - Female
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Hypothermia, Induced/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Patient Safety
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2016/02/13 06:00
MHDA- 2016/08/23 06:00
CRDT- 2016/02/12 06:00
PHST- 2015/08/18 00:00 [received]
PHST- 2016/01/08 00:00 [accepted]
PHST- 2016/02/12 06:00 [entrez]
PHST- 2016/02/13 06:00 [pubmed]
PHST- 2016/08/23 06:00 [medline]
AID - heartjnl-2015-308559 [pii]
AID - 10.1136/heartjnl-2015-308559 [doi]
PST - ppublish
SO  - Heart. 2016 May;102(9):712-9. doi: 10.1136/heartjnl-2015-308559. Epub 2016 Feb 
      10.