title: Adjunctive mild hypothermia therapy to primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction complicated with cardiogenic shock: A pilot feasibility study.
abstract: BACKGROUND
  Despite successful primary reperfusion therapy, patients may develop large myocardial infarction related in part to reperfusion injury. Induction of mild therapeutic hypothermia (TH) applied in patients has demonstrated beneficial effect in reducing reperfusion injury. The aim of the study was to evaluate the feasibility and safety of adjunctive mild TH to primary percutaneous coronary intervention (PPCI) in patients with acute ST elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS).
  
  
  METHODS
  We conducted a prospective single center, open label, historical control study. Patients presenting with STEMI and CS despite maximal support therapy scheduled for PPCI were included. Death was defined as primary endpoint. Secondary outcomes included: TH adverse effect--such as fever, refractory hypotension and arrhythmias, infarct size measured by area under the curve of biomarkers.
  
  
  RESULTS
  Eight consecutive patients were prospectively enrolled (TH group). Thirteen clinically similar patients identified from our database, admitted over 2 years, comprised the historical control group (control group). In the hypothermia group, the mortality was 50% compared with 46% in the control group. There was no difference in the secondary outcomes.
  
  
  CONCLUSIONS
  TH as adjunctive therapy in STEMI patients complicated with CS is feasible and safe. Based on these preliminary observations there appears to be no significant clinical advantage to this form of therapy.
authors.affiliation: Cardiology Department, Assaf Harofeh, Medical Center, Tel Aviv University Tel Aviv. alexb@asaf.health.gov.il.
authors.forename: Alex
authors.initials: A
authors.lastname: Blatt
authors.forename: Gabby Atalya
authors.initials: GA
authors.lastname: Elbaz-Greener
authors.forename: Avi
authors.initials: A
authors.lastname: Mizrachi
authors.forename: Ziad
authors.initials: Z
authors.lastname: J'bara
authors.forename: Tali
authors.initials: T
authors.lastname: Taraboulos
authors.forename: Ilia
authors.initials: I
authors.lastname: Litovchik
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vered
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D065386:Historically Controlled Study; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D007557:Israel; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome