Testori C, et al. - Researchers investigated whether out-of-hospital initiation of hypothermia in awake patients with ST-segment elevation myocardial infarction (STEMI) improves myocardial salvage measured by cardiac MRI (CMR). Emergency medical service started hypothermia within 6 hours of symptom onset with surface cooling pads and cold saline, and this was continued in the cath lab with endovascular cooling (target temperature: ≤ 35°C at time of reperfusion). For these subjects, myocardial salvage index (using CMR) was compared with a not-cooled group of patients at day 4 ± 2 after the event. Findings revealed no improvement in myocardial salvage in STEMI patients who received out-of-hospital induced therapeutic hypothermia as an adjunct to primary percutaneous coronary intervention.