NCT01777750

Brief Summary

The primary goal in the treatment of acute myocardial infarction is to reperfuse the ischemic myocardium to reduce infarct size. Animal data and human data suggest that whole-body cooling to temperatures below 35°C before revascularisation can additionally reduce infarct size and therefore improves outcome in these patients. The purpose of the study is to determine if a combined cooling strategy started in the out-of-hospital arena is able to reduce infarct size in acute myocardial infarction.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Feb 2013

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 23, 2013

Completed
6 days until next milestone

First Posted

Study publicly available on registry

January 29, 2013

Completed
3 days until next milestone

Study Start

First participant enrolled

February 1, 2013

Completed
3.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2016

Completed
2.5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2019

Completed
Last Updated

March 14, 2019

Status Verified

March 1, 2017

Enrollment Period

3.4 years

First QC Date

January 23, 2013

Last Update Submit

March 13, 2019

Conditions

Keywords

Myocardial InfarctionMyocardial Reperfusion InjuryReperfusion InjuryAnterior Wall Myocardial InfarctionInferior Wall Myocardial InfarctionPathologic ProcessesMyocardial Ischemia

Outcome Measures

Primary Outcomes (1)

  • Infarct size (as percentage of myocardium at risk) assessed by cardiac MRI

    The primary objective of this study is to demonstrate a reduction in infarct size (as percentage of myocardium at risk) assessed by cardiac MRI at 4±2 days when ST-elevation myocardial infarction is treated with primary coronary intervention (PCI) plus hypothermia compared to PCI alone

    Day 4±2

Secondary Outcomes (2)

  • Incidence of major adverse cardiac events

    6 months

  • Immune cell activation

    4±2 days

Study Arms (2)

Pre- and perinterventional hypothermia

ACTIVE COMPARATOR

Cooling will be initiated by the application of cooling pads in the out-of-hospital setting followed by an infusion of 1000-2000ml of cold saline. In the cath lab a endovascular cooling catheter will be placed into the inferior vena cava via a femoral vein to achieve a core temperature of \<35°C prior to revascularization.

Device: EMCOOLS flex pad; Philips Innercool RTx

Standard treatment

NO INTERVENTION

Standard treatment

Interventions

Surface cooling with EMCOOLS flex pads (out-of-hospital); Infusion of 1000ml to 2000ml of cold saline (out-of-hospital); central-venous cooling (Philips Inntercool RTx)

Pre- and perinterventional hypothermia

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age between 18 and 75 years
  • Immediate transfer to cath-lab is possible
  • Anterior or inferior ST-segment myocardial infarction
  • ST-Segment elevation of \>0.2mV in 2 or more anatomically contiguous leads
  • Duration of symptoms \<6 hours

You may not qualify if:

  • Participation in another study
  • Patients presenting with cardiac arrest/cardiogenic shock
  • Tympanic temperature \<35.0°C prior to enrolment
  • Thrombolytic therapy
  • Previous MI
  • Previous PCI or coronary artery bypass graft
  • Severe heart failure at presentation (defined as a New York Heart Association (NYHA) functional class III or IV), or Killip classes II through IV
  • Clinical signs of active infection
  • End-stage kidney disease or hepatic failure
  • Recent stroke (within the past six months)
  • Conditions that may be exacerbated by hypothermia, such as haematological dyscrasias, oral anticoagulant treatment with international normalized ratio \>1.5, severe pulmonary disease
  • Pregnancy
  • Women of childbearing potential
  • Allergy to meperidine, buspirone, magnesium, or polyvinyl chloride
  • Use of a monoamine oxidase inhibitor such as selegiline in the previous 14 days
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Medical University of Vienna

Vienna, 1090, Austria

Location

Related Publications (2)

  • Mangold A, Ondracek AS, Hofbauer TM, Scherz T, Artner T, Panagiotides N, Beitzke D, Ruzicka G, Nistler S, Wohlschlager-Krenn E, Winker R, Quehenberger P, Traxler-Weidenauer D, Spannbauer A, Gyongyosi M, Testori C, Lang IM. Culprit site extracellular DNA and microvascular obstruction in ST-elevation myocardial infarction. Cardiovasc Res. 2022 Jun 29;118(8):2006-2017. doi: 10.1093/cvr/cvab217.

  • Testori C, Beitzke D, Mangold A, Sterz F, Loewe C, Weiser C, Scherz T, Herkner H, Lang I. Out-of-hospital initiation of hypothermia in ST-segment elevation myocardial infarction: a randomised trial. Heart. 2019 Apr;105(7):531-537. doi: 10.1136/heartjnl-2018-313705. Epub 2018 Oct 25.

MeSH Terms

Conditions

ST Elevation Myocardial InfarctionMyocardial InfarctionMyocardial Reperfusion InjuryReperfusion InjuryAnterior Wall Myocardial InfarctionInferior Wall Myocardial InfarctionPathologic ProcessesMyocardial Ischemia

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathological Conditions, Signs and SymptomsNecrosisCardiomyopathiesPostoperative Complications

Study Officials

  • Christoph Testori, MD

    Medical University of Vienna, Dept. of Emergency Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Department of Emergency Medicine

Study Record Dates

First Submitted

January 23, 2013

First Posted

January 29, 2013

Study Start

February 1, 2013

Primary Completion

July 1, 2016

Study Completion

January 1, 2019

Last Updated

March 14, 2019

Record last verified: 2017-03

Locations