Increased Body Temperature After Reperfused Acute Myocardial Infarction Is Associated With Adverse Left Ventricular Remodeling

• Published in: Journal of cardiac failure 2007-02, Vol.13 (1), p.25-33
• Main Authors: Naito, Kotaro, MD, Anzai, Toshihisa, MD, Yoshikawa, Tsutomu, MD, FACC, Maekawa, Yuichiro, MD, Sugano, Yasuo, MD, Kohno, Takashi, MD, Mahara, Keitaro, MD, Okabe, Teruo, MD, Asakura, Yasushi, MD, Ogawa, Satoshi, MD, FACC
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Adult; Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary; Body Temperature; Cardiovascular; Female; Fever; Fever - etiology; Fever - physiopathology; Humans; Immune system; Inflammation; 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
• ISSN: 1071-9164; 1532-8414
• 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.