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


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.
Naito
Kotaro
K
Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Anzai
Toshihisa
T
Yoshikawa
Tsutomu
T
Maekawa
Yuichiro
Y
Sugano
Yasuo
Y
Kohno
Takashi
T
Mahara
Keitaro
K
Okabe
Teruo
T
Asakura
Yasushi
Y
Ogawa
Satoshi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001831:Body Temperature; D005260:Female; D005334:Fever / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D015425:Myocardial Reperfusion; D018377:Neurotransmitter Agents / Q000097:blood; D011379:Prognosis; D015912:Thrombolytic Therapy; D020257:Ventricular Remodeling / Q000502:physiology*
D015850:Interleukin-6; D018377:Neurotransmitter Agents