Observational studyBMC medicine2025
Therapeutic hypothermia in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest.
Observational study in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05724914 (Clinical Impact in Patients With Delayed Hospitalization in Patients With Out-of-hospital Cardiac Arrest), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Impact in Patients With Delayed Hospitalization in Patients With Out-of-hospital Cardiac Arrest
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0 citing papers in PubMed.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a lack of data regarding outcomes of therapeutic hypothermia in patients with acute myocardial infarction (AMI) complicated by out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the effect of therapeutic hypothermia on clinical outcomes in comatose patients after percutaneous coronary intervention (PCI) for AMI following OHCA.
methodsUsing a prospective nationwide registry from 2016 to 2021, we selected 2925 patients with AMI who underwent emergency PCI among 182,508 OHCA cases. These patients were divided into groups receiving hypothermia treatment (n = 624) and those not receiving hypothermia treatment (n = 2301). The primary endpoint was in-hospital mortality, and secondary endpoints were mortality rate at 24 h and neurological outcomes at discharge.
resultsThe hypothermia group showed a significantly lower rate of in-hospital mortality than the non-hypothermia group (odds ratio [OR] 0.71; 95% confidence interval [CI], 0.59-0.85; P < 0.001). However, there was no significant difference in neurological outcomes at discharge between the two groups. Furthermore, quartile analysis of door-to-cooling (DtC) time, defined as the time from hospital arrival to initiation of hypothermia, demonstrated that a shorter DtC time was associated with a decreased risk of mortality and poor neurological outcomes (mortality: adjusted OR, 0.40; 95% CI, 0.30-0.54; P < 0.001; poor neurological outcome: adjusted OR, 0.59; 95% CI, 0.45-0.77; P < 0.001 for quartile 1 versus quartile 4).
conclusionsTherapeutic hypothermia reduced the rate of in-hospital mortality in patients with AMI complicated by OHCA. Moreover, early initiation of hypothermia demonstrated a reduction in mortality and poor neurological outcomes. PRE-REGISTERED CLINICAL TRIAL NUMBER: URL: http://clinicaltrials.gov . Unique identifier: NCT05724914. In this large, government-controlled, nationwide, prospective real-world registry with AMI and complicated by OHCA, we demonstrated therapeutic hypothermia reduced the rate of in-hospital mortality, but it did not improve neurological outcomes at discharge. Our findings also showed that early initiation of hypothermia was significantly associated with reduced in-hospital mortality and poor neurological outcomes. The findings of this study suggest that therapeutic hypothermia reduces in-hospital mortality in patients with AMI complicated by OHCA. Early application of hypothermia should be considered as a potential means of improving neurological outcomes in patients with AMI-OHCA undergoing emergency PCI.
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