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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Fever after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction is associated
Hyun-Ok Cho1, Chang-Wook Nam2, Ho-Myung Lee2
1Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea; Andong Medical Group, Andong, Republic of Korea.
Insights
Fever following primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is common and predicts adverse cardiovascular events. This indicates fever is a significant prognostic marker post-PPCI.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Fever is a frequent complication post-primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) patients.
- The prognostic significance of post-PPCI fever remains inadequately validated.
Purpose of the Study:
- To investigate the association between fever after PPCI and adverse clinical outcomes in STEMI patients.
- To determine if fever is an independent predictor of major adverse cardiovascular events (MACE).
Main Methods:
- A cohort of 514 STEMI patients undergoing PPCI was studied.
- Patients were categorized based on peak body temperature (BT) post-PPCI: ≤37.6 °C (control) and >37.6 °C (fever group).
- One-year MACE rates (death, myocardial infarction, revascularization) were compared between groups.
Main Results:
- Fever (peak BT >37.6 °C) occurred in 24.7% of patients and was associated with elevated inflammatory markers.
- The fever group exhibited a higher rate of 1-year MACE (11.0% vs. 4.7%, p=0.010).
- Multivariate analysis identified fever as an independent predictor of 1-year MACE (OR 2.358, p=0.025).
Conclusions:
- Fever is a common occurrence after PPCI in STEMI patients.
- Post-PPCI fever is a significant predictor of adverse clinical outcomes, including MACE.
- These findings highlight the prognostic value of monitoring fever post-PPCI.
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 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.
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