Efficacy and Safety of Therapeutic Hypothermia as an Adjuvant Therapy for Percutaneous Coronary Intervention in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

• Published in: Therapeutic hypothermia and temperature management Vol. 14; no. 3; p. 152
• Main Authors: Mir, Ali, Rahman, Mohammed Faraaz, Ragab, Khaled Mohamed, Fathallah, Ahmed Hashem, Daloub, Shaden, Alwifati, Nader, Hagrass, Abdulrahman Ibrahim, Nourelden, Anas Zakarya, Elsayed, Sarah Makram, Kamal, Ibrahim, Elhady, Mahmoud M, Khan, Raheel
• Format: Journal Article
• Language: English
• Published: United States 01.09.2024
• Subjects: Humans; Hypothermia, Induced - adverse effects; Hypothermia, Induced - methods; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Treatment Outcome; meta-analysis; percutaneous coronary intervention; hypothermia; PCI; myocardial infarction
• ISSN: 2153-7933
• DOI: 10.1089/ther.2023.0007

The study aims to compare the use of hypothermia in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) with control. We systematically searched four electronic databases until March 2022. The inclusion criteria were any study design that compared hypothermia in patients with MI undergoing PCI with control. The risk of bias assessment of the included randomized controlled trials was conducted through Cochrane Tool, while the quality of the included cohort studies was assessed by the NIH tool. The meta-analysis was performed on RevMan. A total of 19 studies were entered. Regarding the mortality, there were nonsignificant differences between hypothermia and control (odds ratio [OR] = 1.06, 95% confidence interval [CI] 0.75 to 1.50,  = 0.73). There was also no significant difference between the control and hypothermia in recurrent MI (OR = 1.21, 95% CI 0.64 to 2.30,  = 0.56). On the other hand, the analysis showed a significant favor for hypothermia over the control infarct size (mean difference = -1.76, 95% CI -3.04 to -0.47,  = 0.007), but a significant favor for the control over hypothermia in the overall bleeding complications (OR = 1.88, 95% CI 1.11 to 3.18,  = 0.02). Compared with the control, hypothermia reduced the infarct size of the heart, but this finding was not consistent across studies. However, the control had lower rates of bleeding problems. The other outcomes, such as death and the incidence of recurrent MI, were similar between the two groups.