The timely revascularization of an occluded coronary artery is the cornerstone of treatment in patients with
ST-elevation myocardial infarction (
STEMI). As essential as this treatment is, it can also cause additional damage to cardiomyocytes that were still viable before reperfusion, increasing
infarct size. This has been termed "
myocardial reperfusion injury". To date, there is still no effective treatment for
myocardial reperfusion injury in patients with
STEMI. While numerous attempts have been made to overcome this hurdle with various
experimental therapies, the common denominator of these
therapies is that, although they often work in the preclinical setting, they fail to demonstrate the same results in human trials.
Hypothermia is an example of such a
therapy. Although promising results were derived from experimental studies, multiple randomized controlled trials failed to do the same. This review includes a discussion of
hypothermia as a potential treatment for
myocardial reperfusion injury, including lessons learned from previous (negative) trials, advanced techniques and materials in current hypothermic treatment, and the possible future of
hypothermia for cardioprotection in patients with
STEMI.