Goal 2: Reduce Human Disease

Early cardioprotection for acute MI through cooling

What is an appropriate mechanism and study design to evaluate the beneficial effects of hypothermia following acute myocardial infarction?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Acute myocardial infarction remains a major cause of morbidity and mortality. Additional therapies beyond reperfusion are required to improve outcome.

Feasibility and challenges of addressing this CQ or CC

Proof of concept has been established to support the acute effects of cooling in experimental models as well as humans.
Induction of hypothermia has proven dramatically effective in reducing myocardial infarct size in experimental models. Most studies in humans for STEMI have also shown a reduction in infarct size for subjects with anterior MIs cooled to below 35 degrees prior to reperfusion. However, long-term outcomes, including survival rates, LV remodeling, and prevention of heart failure, are unknown. Early treatment during transport to a hospital with a cardiac catheterization laboratory may be the most critical application for such a method. Ensuring trained first responders, community consent, appropriate study design, and financial support to assess long-term effects are a challenge. Simple methods of quickly and adequately ensuring consistent cooling are emerging.

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Idea No. 285