Increased body temperature after reperfused acute myocardial infarction is associated with adverse left ventricular remodeling

J Card Fail. 2007 Feb;13(1):25-33. doi: 10.1016/j.cardfail.2006.09.006.

Abstract

Background: Fever is frequently observed in patients with acute myocardial infarction (AMI); however, its prognostic significance remains to be determined. We sought to determine the prognostic significance of increased body temperature (BT) after AMI.

Methods and results: We examined 156 consecutive patients with reperfused first anterior AMI. Axillary BT was serially measured every 6 hours for a week. Patients were divided into quartiles by peak BT from the lowest to highest levels. Peak BT within the first week showed a significant positive correlation with peak C-reactive protein level (P < .0001), but not with peak creatine kinase level. There were positive correlations of peak BT with the incidence of pump failure (P = .022), left ventricular (LV) aneurysm (P = .029), and readmission for heart failure (P = .006). Higher peak BT was associated with greater LV end-diastolic volume (P = .031), greater end-systolic volume (P = .008), and lower LV ejection fraction (P = .014) 2 weeks after AMI. Multiple logistic regression analyses revealed that peak BT quartile was an independent predictor of in-hospital cardiac events (odds ratio = 1.61/quartile, P = .008). Furthermore, peak BT quartile was a significant predictor of readmission for heart failure by Cox proportional hazard model analysis (P = .048).

Conclusions: Increased BT after AMI was associated with a worse clinical outcome and infarct expansion, suggesting a relationship between systemic inflammatory response and LV remodeling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary
  • Body Temperature
  • Female
  • Fever / etiology
  • Fever / physiopathology*
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / complications
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / therapy*
  • Myocardial Reperfusion*
  • Neurotransmitter Agents / blood
  • Prognosis
  • Thrombolytic Therapy
  • Ventricular Remodeling / physiology*

Substances

  • Interleukin-6
  • Neurotransmitter Agents