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Fever after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction is associated with adverse outcomes.
MedLine Citation:
PMID:  24290071     Owner:  NLM     Status:  Publisher    
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.
OBJECTIVES: 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 6h for 5days 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±49.4mg/L vs. 7.4±2.5mg/L, p=0.001, 16.7±36.9ng/dl vs. 8.70±26.2ng/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.
Hyun-Ok Cho; Chang-Wook Nam; Ho-Myung Lee; Hong-Won Shin; Yun-Kyeong Cho; Hyuck-Jun Yoon; Hyoung-Seob Park; Hyungseop Kim; In-Sung Chung; Seung-Ho Hur; Yoon-Nyun Kim; Kwon-Bae Kim
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-11
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-12-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea; Andong Medical Group, Andong, Republic of Korea.
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