Selective intracoronary hypothermia in patients with ST-elevation myocardial infarction. Rationale and design of the EURO-ICE trial

Introduction

In ST-elevation myocardial infarction (STEMI), early restoration of blood flow, preferably by primary percutaneous coronary intervention (PPCI), is paramount to limit infarct size (IS) and improve long-term outcomes1. However, reperfusion by itself may also cause damage to the myocardium and increase IS. This has been termed myocardial reperfusion injury2.

In animal models of acute myocardial infarction, it has been demonstrated that hypothermia decreases IS3. In contrast, human studies applying systemic cooling methods have not yet been able to confirm this protective effect. Recently, we developed a new method to provide selective intracoronary hypothermia during PPCI4. The ...