Increased Body Temperature After Reperfused Acute Myocardial Infarction Is Associated With Adverse Left Ventricular Remodeling

Serious Infection After Acute Myocardial Infarction

“…However, it can often be a clinical challenge to determine whether the fever is due to the MI, to a complicating infection, or to other causes of systemic inflammation. Regardless of the etiology, because fever has a strong influence on oxygen consumption, it is important to recognize preventable or treatable underlying causes of fever that might predispose a patient to infarct extension and greater infarct size (19,20). …”

“…In their study, fever was correlated with high-sensitivity C-reactive protein but not with fibrinogen levels or white blood cell count. Subsequently, Naito and colleagues found that fever after acute MI was associated with worse clinical outcome and with infarction expansion, suggesting a relationship between systemic inflammatory response and left ventricular remodeling in the post-infarction period (20). Further, the rates of death due to pump failure, malignant arrhythmias, and cardiac failure increased significantly with increasing quartile of body temperature (20).…”

Cardiogenic Causes of Fever

“…There have been no systematic studies on the administration of antipyretics to patients who have suffered myocardial infarction. In contrast, several studies have investigated the induction of therapeutic hypothermia before or during a percutaneous coronary intervention with the aim of limiting infarct size (16,19,20). However, none of these studies has yet demonstrated convincingly that induction of mild hypothermia during a myocardial infarction is of any benefit to the patient (21,22).…”

“…Higher levels of both inflammatory cytokines (e.g., interleukin-6, leukocytes, and hs-CRP) and neurohormones (e.g., brain natriuretic peptide, BNP) can be detected in patients with increased temperature. This seems to be clinically relevant: In the study by Naito et al, body temperature ≥ 38 °C was correlated with reduced left ventricular pump function, aneurysm formation, and rehospitalization due to heart failure (16).…”

“…This can be prevented by early administration of a beta-blocker (15). It remains unclear, however, whether body temperature is correlated with infarct size (16). In fact, temperature reflects the activity of inflammatory processes.…”