Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction.


Journal

Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763

Informations de publication

Date de publication:
22 01 2019
Historique:
pubmed: 22 7 2018
medline: 19 11 2019
entrez: 21 7 2018
Statut: ppublish

Résumé

Experimental trials suggest improved outcome by mild therapeutic hypothermia for cardiogenic shock after acute myocardial infarction. The objective of this study was to investigate the hemodynamic effects of mild therapeutic hypothermia in patients with cardiogenic shock complicating acute myocardial infarction. Patients (n=40) with cardiogenic shock undergoing primary percutaneous coronary intervention without classic indications for mild therapeutic hypothermia underwent randomization in a 1:1 fashion to mild therapeutic hypothermia for 24 hours or control. The primary end point was cardiac power index at 24 hours; secondary end points included other hemodynamic parameters and serial measurements of arterial lactate. No relevant differences were observed for the primary end point of cardiac power index at 24 hours (mild therapeutic hypothermia versus control: 0.41 [interquartile range, 0.31-0.52] versus 0.36 [interquartile range, 0.31-0.48] W/m In this randomized trial, mild therapeutic hypothermia failed to show a substantial beneficial effect on cardiac power index at 24 hours in patients with cardiogenic shock after acute myocardial infarction. URL: https://www.clinicaltrials.gov . Unique identifier: NCT01890317.

Sections du résumé

BACKGROUND
Experimental trials suggest improved outcome by mild therapeutic hypothermia for cardiogenic shock after acute myocardial infarction. The objective of this study was to investigate the hemodynamic effects of mild therapeutic hypothermia in patients with cardiogenic shock complicating acute myocardial infarction.
METHODS
Patients (n=40) with cardiogenic shock undergoing primary percutaneous coronary intervention without classic indications for mild therapeutic hypothermia underwent randomization in a 1:1 fashion to mild therapeutic hypothermia for 24 hours or control. The primary end point was cardiac power index at 24 hours; secondary end points included other hemodynamic parameters and serial measurements of arterial lactate.
RESULTS
No relevant differences were observed for the primary end point of cardiac power index at 24 hours (mild therapeutic hypothermia versus control: 0.41 [interquartile range, 0.31-0.52] versus 0.36 [interquartile range, 0.31-0.48] W/m
CONCLUSIONS
In this randomized trial, mild therapeutic hypothermia failed to show a substantial beneficial effect on cardiac power index at 24 hours in patients with cardiogenic shock after acute myocardial infarction.
CLINICAL TRIAL REGISTRATION
URL: https://www.clinicaltrials.gov . Unique identifier: NCT01890317.

Identifiants

pubmed: 30026282
pii: CIRCULATIONAHA.117.032722
doi: 10.1161/CIRCULATIONAHA.117.032722
doi:

Substances chimiques

Biomarkers 0
Lactic Acid 33X04XA5AT

Banques de données

ClinicalTrials.gov
['NCT01890317']

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

448-457

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn

Auteurs

Georg Fuernau (G)

Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Luebeck, University Hospital Schleswig-Holstein (G.F., S.D., I.E., A.J., S.d.W.-T), University of Luebeck, Germany.
German Center for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung [DZHK]), Partner Site Hamburg/Kiel/Lübeck, Luebeck, Germany (G.F., S.D., I.E., A.J., S.d.W.-T).
Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Johannes Beck (J)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Steffen Desch (S)

Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Luebeck, University Hospital Schleswig-Holstein (G.F., S.D., I.E., A.J., S.d.W.-T), University of Luebeck, Germany.
German Center for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung [DZHK]), Partner Site Hamburg/Kiel/Lübeck, Luebeck, Germany (G.F., S.D., I.E., A.J., S.d.W.-T).
Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Ingo Eitel (I)

Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Luebeck, University Hospital Schleswig-Holstein (G.F., S.D., I.E., A.J., S.d.W.-T), University of Luebeck, Germany.
German Center for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung [DZHK]), Partner Site Hamburg/Kiel/Lübeck, Luebeck, Germany (G.F., S.D., I.E., A.J., S.d.W.-T).
Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Christian Jung (C)

Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany (C.J.).

Sandra Erbs (S)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Norman Mangner (N)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Philipp Lurz (P)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Karl Fengler (K)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Alexander Jobs (A)

Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Luebeck, University Hospital Schleswig-Holstein (G.F., S.D., I.E., A.J., S.d.W.-T), University of Luebeck, Germany.
German Center for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung [DZHK]), Partner Site Hamburg/Kiel/Lübeck, Luebeck, Germany (G.F., S.D., I.E., A.J., S.d.W.-T).

Reinhard Vonthein (R)

Institute of Medical Biometry and Statistics and Center for Clinical Trials (R.V.), University of Luebeck, Germany.

Suzanne de Waha-Thiele (S)

Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Luebeck, University Hospital Schleswig-Holstein (G.F., S.D., I.E., A.J., S.d.W.-T), University of Luebeck, Germany.
German Center for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung [DZHK]), Partner Site Hamburg/Kiel/Lübeck, Luebeck, Germany (G.F., S.D., I.E., A.J., S.d.W.-T).
Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Marcus Sandri (M)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Gerhard Schuler (G)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

Holger Thiele (H)

Department of Internal Medicine/Cardiology, Heart Center Leipzig-University Hospital, Germany (G.F., J.B., S.D., I.E., S.E., N.M., P.L., K.F., S.d.W.-T, M.S., G.S., H.T.).

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