Neurologic outcome in patients with cardiac arrest complicating ST elevation myocardial infarction treated by mild therapeutic hypothermia: The experience of a tertiary institution.
OBJECTIVE
Therapeutic hypothermia improves neurologic prognosis after cardiac arrest. The aim of this study was to report clinical experience with intravascular method of cooling in patients with cardiac arrest resulting from ST-segment elevation myocardial infarction (STEMI).


METHODS
Thirteen patients (11 male, 2 famele; mean age was 39.6±9.4 years) who had undergone mild therapeutic hypothermia (MTH) by intravascular cooling after cardiac arrest due to STEMI were included. Clinical, demographic, and procedural data were analyzed. Neurologic outcome was assessed by Cerebral Performance Category (CPC) score.


RESULTS
Anterior STEMI was observed in 9 patients. One patient died of cardiogenic shock complicating STEMI. Mean cardiopulmonary resuscitation (CPR) duration and door-to-invasive cooling were 32.9±20.1 and 286.1±182.3 minutes, respectively. Precooling Glasgow Coma Scale score was 3 in 9 subjects. Twelve patients were discharged, 11 with CPC scores of 1 at 1-year follow-up. No major complication related to procedure was observed.


CONCLUSIONS
In comatose survivors of STEMI, therapeutic hypothermia by intravascular method is a feasible and safe treatment modality.
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey. dremrearugaslan@gmail.com.
Emre
E
Aruğaslan
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Mehmet
M
Karaca
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Kazım Serhan
KS
Özcan
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Ahmet
A
Zengin
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Mustafa Adem
MA
Tatlısu
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Emrah
E
Bozbeyoğlu
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Seçkin
S
Satılmış
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Özlem
Ö
Yıldırımtürk
Department of Cardiovascular Surgery, Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
İbrahim
İ
Yekeler
Department of Cardiology, Medipol University Faculty of Medicine, İstanbul, Turkey.
Zekeriya
Z
Nurkalem
D000328:Adult; D003128:Coma; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D062606:Tertiary Care Centers