Proteomics in Hypothermia as Adjunctive Therapy in Patients with ST-Segment Elevation Myocardial Infarction: A CHILL-MI Substudy

Therapeutic hypothermia studied in patients with ST-segment elevation myocardial infarction (STEMI). Hypothermia is sometimes used as adjunctive therapy to percutaneous coronary intervention (PCI) for these patients. This study aimed to look at the effects of therapeutic hypothermia at the protein level to assess whether this treatment itself affects the levels of biomarkers that may be used to monitor CVD patients.

119 patients with STEMI were randomized into groups that did or did not receive therapeutic hypothermia and samples were obtained at baseline (0 hour), 6, 24, and 96 hours post-PCI. Peak levels of proteins were measured at these time points using the CVD I and Inflammation panels. Four biomarkers (BDNF, DNER, CCL20, MMP3) were reduced in the hypothermia group as compared with the control group, whereas OPG, FGF21, FS, IL12B, PRL, TIM, IL6 were slightly elevated.

This suggests that the adjunct treatment can effect the levels of biomarker expression and should be factored into any biomarker-based investigations in this scenario. However: 1) the analysis was based on peak values only (providing no information on potential temporal effects, 2) no adjustments were made for multiple testing, weakening any conclusions made. For example, there were significant difference in the baseline (pre-treatment) levels of some of the markers in these supposedly randomized groups.