Abstract 17471: Adjunctive Hypothermia for Patients With ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Controversy With Disheartening Results!

Objective: This meta-analysis aims to assess the effectiveness of hypothermia as an adjunctive therapy in percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI).

Methods: A comprehensive literature search was conducted using electronic databases to identify relevant studies published up until May 2023. Studies investigating the use of adjunctive hypothermia in STEMI patients undergoing PCI were included. Data on clinical outcomes, including mortality, infarct size, left ventricular function, major adverse cardiac events (MACE), and microvascular obstruction, were extracted and analyzed.

Results: A total of 8 studies involving 488 patients were included in this meta-analysis. The pooled analysis revealed no significant difference in all-cause mortality between the adjunctive hypothermia group and the control group (risk ratio [RR] = 0.65; 95% confidence interval [CI] 0.30-1.43). There was no significant difference in MACE rates between the two groups (RR = 1.53; 95% confidence interval [CI] 0.66-3.53). Additionally, no significant differences were observed in infarct size, left ventricular function, or microvascular obstruction.

Conclusion: While previously believed to show promise, hypothermia as an adjunctive therapy in PCI fails to achieve any significant superiority over standard interventions according to our analysis. Nevertheless, our findings should be interpreted with caution, taking into account the limitations we faced in our analysis such as the small number of studies available in the literature. Continued research efforts on bigger sample sizes are essential to either refine or refute the current findings.