Target Temperature Management In Myocardial Infarction - A Pilot Study

Target Temperature Management In Myocardial Infarction - A Pilot Study

The primary goal in the treatment of acute myocardial infarction is to reperfuse the ischemic myocardium to reduce infarct size. Animal data and human data suggest that whole-body cooling to temperatures below 35°C before revascularisation can additionally reduce infarct size and therefore improves outcome in these patients.

The purpose of the study is to determine the feasibility and safety of a combined cooling strategy started in the out-of-hospital arena for achieving pre-reperfusion hypothermia in patients with acute st-elevation myocardial infarction.

Inclusion Criteria:

• Age between 18 and 75 years
• Immediately transfer to cath-lab is possible
• Anterior or inferior ST-Elevation myocardial infarction
• ST-Segment elevation of >0.2mV in 2 or more anatomically contiguous leads
• Duration of symptoms <6 hours

Exclusion Criteria:

• Participation in another study
• Patients presenting with cardiac arrest
• Tympanic temperature of <35.0°C prior enrolment
• Thrombolysis therapy
• Previous myocardial infarction in medical history
• Previous percutaneous coronary intervention or coronary artery bypass graft
• Severe heart failure (defined as a New York Heart Association (NYHA) score of III or IV), Killip class II through IV at presentation
• Clinical signs of infection
• End-stage kidney disease or hepatic failure
• Recent stroke (within the last six month)
• Conditions that may be exacerbated by hypothermia, such as haematological dyscrasias, oral anticoagulant treatment with international normalized radio >1.5, severe pulmonary disease
• Pregnancy. Women of childbearing potential are excluded
• Allergy to meperidine, buspirone, magnesium, or polyvinyl chloride
• Use of a monoamine oxidase inhibitor such as selegiline in the previous 14 days