title: Fever after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction is associated with adverse outcomes.
abstract: BACKGROUND
  Fever is a common finding after primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI). However, its prognostic value is not validated yet.
  
  
  OBJECTIVE
  This study sought to evaluate the impact of fever after PPCI in STEMI on adverse clinical outcomes.
  
  
  METHODS
  Five hundred fourteen consecutive patients who underwent PPCI due to STEMI were enrolled. Body temperature (BT) was checked every 6 h for 5 days after PPCI. Patients were divided into two groups according to the highest quartile of peak BT; peak BT≤37.6 °C (control group) and peak BT>37.6 °C (fever group). Rates of 1-year major adverse cardiovascular events (MACE; death, myocardial infarction, any revascularization) were compared.
  
  
  RESULTS
  The prevalence of fever group (peak BT>37.6 °C) was 24.7% (127/514). White blood cell count, highly sensitive C-reactive protein and serum cardiac troponin I level were higher in fever group than control group (12,162±4199/μL vs. 10,614±3773/μL, p<0.001; 22.9±49.4 mg/L vs. 7.4±2.5 mg/L, p=0.001, 16.7±36.9 ng/dl vs. 8.70±26.2 ng/dl, p=0.027, respectively). The frequency of a history of previous myocardial infarction and left ventricular ejection fraction was lower in fever group (0.0% vs. 4.7%, p=0.010; 47±8 % vs. 49±9 %, p=0.002, respectively). There was no significant difference in angiographic characteristics between 2 groups. 1-year MACE rates were higher in fever group (11.0% vs. 4.7%, p=0.010). Multivariate analysis revealed fever (OR 2.358, 95% CI 1.113-4.998, p=0.025), diabetes mellitus as risk factor (2.227, 1.031-4.812, 0.042), and left anterior descending artery as infarct related artery (2.443, 1.114-5.361, 0.026) as independent predictors for 1-year MACE.
  
  
  CONCLUSIONS
  Fever after PPCI in patients with STEMI is frequently developed and it can predict adverse clinical outcome.
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea; Andong Medical Group, Andong, Republic of Korea.
authors.forename: Hyun-Ok
authors.initials: HO
authors.lastname: Cho
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea. Electronic address: ncwcv@dsmc.or.kr.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Ho-Myung
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Hong-Won
authors.initials: HW
authors.lastname: Shin
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Hyuck-Jun
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Hyoung-Seob
authors.initials: HS
authors.lastname: Park
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Hyungseop
authors.initials: H
authors.lastname: Kim
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Chung
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Yoon-Nyun
authors.initials: YN
authors.lastname: Kim
authors.affiliation: Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Kwon-Bae
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Fever; Myocardial infarction; Outcome; Percutaneous coronary intervention