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 patientswith 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 N 37.6 °C (fever group). Rates of 1-year major adverse cardiovascular events (MACE; death, myocardial infarction, any revascularization) were compared. Results:Theprevalenceof fevergroup(peakBT N 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 b 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.