Document Detail


Effect of cooling after human cardiac arrest on myocardial infarct size.
MedLine Citation:
PMID:  18951682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The Hypothermia after Cardiac Arrest (HACA) trial assessed whether mild therapeutic hypothermia improved the rate of good neurological recovery in patients after ventricular fibrillation cardiac arrest of presumed cardiac origin. We evaluated the impact of hypothermia on myocardial injury. METHODS: Re-analysis of a HACA trial subset for our department (cooling, n=55; controls, n=56). Plasma levels of CK, CKMB and ST-scores were used as a measure of infarct size. RESULTS: Area under the curve (AUC) for CK was 28,786U/l x 24 h (IQR 5646-44,998) in the cooling group and 20,373U/l x 24 h (IQR 8211-30,801) for controls (p=0.40), for CKMB AUC was 1691U/l x 24 h (IQR 724-3330) and 1187U/l x 24 h (IQR 490-2469), respectively (p=0.18). The ST score was -40% (IQR [-55]-[+16]) in the cooling group (n=23) and -22% (IQR [-84]-[+33]) for controls (n=24) (p=0.76). When the cooling group was stratified into early (< or =8h) and longer (>8h) time to target temperature, the early group displayed a significantly lower CK 7340U/l x 24 h (IQR 3921-33,753) vs. 38,986U/l x 24 h (IQR 23,945-57,514, p=0.007) and a lower CKMB. CONCLUSION: Cooling after successful resuscitation for ventricular fibrillation cardiac arrest did not influence infarct size. Cautious interpretation of the subgroup analysis may indicate a favourable trend for early cooling.
Authors:
Maria Koreny; Fritz Sterz; Thomas Uray; Wolfgang Schreiber; Michael Holzer; Anton Laggner; Harald Herkner
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-10-31
Journal Detail:
Title:  Resuscitation     Volume:  80     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-03-10     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20/6D, A-1090 Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Creatine Kinase, MB Form / blood
Electrocardiography
Female
Heart Arrest / blood,  diagnosis,  therapy*
Humans
Hypothermia, Induced*
Male
Middle Aged
Myocardial Infarction / blood,  diagnosis,  therapy*
Resuscitation / methods
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase, MB Form

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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