Selective intracoronary hypothermia in patients with ST-elevation myocardial infarction: rationale and design of the EURO-ICE Trial

In ST-elevation myocardial infarction (STEMI), early restoration of blood flow, preferably by primary percutaneous coronary intervention (PPCI), is paramount to limit infarct size (IS) and improve long-term outcomes 1. However, reperfusion by itself may also cause damage to the myocardium and increase IS. This has been termed myocardial reperfusion injury 2. In animal models of acute myocardial infarction, it has been demonstrated that hypothermia decreases IS 3. In contrast, human studies applying systemic cooling methods have not yet been able to confirm this protective effect. Recently, we developed a new method to provide selective intracoronary hypothermia during PPCI 4. The EUROpean Intracoronary Cooling Evaluation in patients with ST-elevation myocardial infarction (EURO-ICE) trial will assess the efficacy of this method. Methods STUDY OBJECTIVES The primary objective of the EURO-ICE trial is to evaluate the effect of selective intracoronary hypothermia (SIH) on IS