We measured body temperature in 40 consecutive patients treated for a first ST elevation acute myocardial infarction (AMI) with primary percutaneous coronary interventions. Left ventricular function was assessed by echocardiography, and blood samples were drawn for highly sensitive C-reactive protein (hs-CRP), white blood cell (WBC) count, fibrinogen, creatine kinase (CK), and cardiac troponin I levels (cTnI). The median (25th, 75th quartiles) peak 24-hour temperature was 37.4°C (36.9°C, 37.6°C). Variables significantly associated with peak 24-hour temperature were CK (p = 0.01, r = 0.42), wall motion index (p = 0.01, r = 0.41), hs-CRP (p = 0.01, r = 0.41), and cTnI (p = 0.03, r = 0.35). There was no significant correlation between peak 24-hour temperature and WBC count (p = 0.39, r = 0.14) and fibrinogen (p = 0.12, r = 0.21). Thus, peak 24-hour body temperature after ST elevation AMI probably reflects infarct size rather than a nonspecific inflammatory response.

Keywords:
Myocardial infarction, Fever, Body temperature, Inflammation, Infarct size
1.
Risøe C, Kirkeby OJ: Reduction of the pyrexial response to acute myocardial infarction by beta-adrenoreceptor blockade. Acta Med Scand 1986;219:271–274.
2.
Lofmark R, Nordlander R, Orinius E: The temperature course in acute myocardial infarction. Am Heart J 1978;96:153–156.
3.
Master AM, Dack S, Jaffe HL: Coronary thrombosis: An investigation of heart failure and other factors in its course and prognosis. Am Heart J 1937;13:330.
4.
Kuchinskii AP: Fever in myocardial infarction, its relation with catecholamine excretion and disorders of heart rhythm. Ter Arkh 1982;54:53–56.
5.
Hale SL, Kloner RA: Elevated body temperature during myocardial ischemia/reperfusion exacerbates necrosis and worsens no-reflow. Coron Artery Dis 2002;13:177–181.
6.
Herlitz J, Bengtson A, Hjalmarson A, Wilhelmsen L: Body temperature in acute myocardial infarction and its relation to early intervention with metoprolol. Int J Cardiol 1988;20:65–71.
7.
Risoe C, Kirkeby OJ: Reduction of the pyrexial response to acute myocardial infarction by beta-adrenoceptor blockade. Acta Med Scand 1986;219:271–274.
8.
Risoe C, Kirkeby OJ, Grottum P, Sederholm M, Kjekshus JK: Fever after acute myocardial infarction in patients treated with intravenous timolol or placebo. Br Heart J 1987;57:28–31.
9.
Woodhead RL: Fever in relation to serum enzyme change in acute myocardial infarction. Am Heart J 1974;88:813–814.
10.
Hochman JS: Cardiogenic shock complicating acute myocardial infarction. Cirulation 2003;107:2998–3002.
11.
Gabriel AS, Ahnve S, Wretlind B, Martinsson A: IL-6 and IL-1 receptor antagonist in stable angina pectoris and relation of IL-6 to clinical findings in acute myocardial infarction. J Intern Med 2000;248:61–66.
12.
Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, Douglas PS, Faxon DP, Gillam LD, Kimball TR: ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2003:42;954–970.
13.
Gibson TC: The significance of fever in acute myocardial infarction: A reappraisal. Am Heart J 1974;87:439–444.
14.
Pereira D, Linder J, Rabacal C, Riberio H, Nuno L, Carvalho E, Afonso JS, Fernandes JS: Fever in the first 48 hours of an acute myocardial infarct treated with fibrinolytics – an indicator of nonreperfusion of the coronary vessels? Rev Port Cardiol 1993;12:725–729.
15.
Berk B, Weintraub W, Alexander W: Elevation of C-reactive protein in ‘active’ coronary artery disease. Am J Cardiol 1990;65:168–172.
16.
Liuzzo G, Biasucci LM, Gallimore JR: The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina. N Engl J Med 1994;331:417–424.
17.
Liuzzo G, Biasucci LM, Gallimore JR: Enhaced inflammatory response in patient with preinfarction unstable angina. J Am Coll Cardiol 1999;34:1696–1703.
18.
Biasucci LM, Vitelli A, Liuzzo G: Elevated levels of interleukin-6 in unstable angina. Circulation 1996;94:874–877.
19.
Morrow DA, Rifai N, Antman EM: C-reactive protein is a potent predictor of mortality independently and in combination with troponin T in acute coronary syndromes: A TIMI11A substudy. J Am Coll Cardiol 1998;31:1460–1465.
20.
Toss H, Lindahl B, Siegbahn A: Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. Circulation 1997;96:4204–4210.
21.
Lindahl B, Toss H, Siegbahn A: Markers of myocardial damage and inflammtion in relation to long-term mortality in unstable coronary artery disease. N Engl J Med 2000;343:1139–1147.
22.
Heeschen C, Hamm CW, Bruemmer J, Simmoons ML: Predictive value of C-reactive protein and troponin T in patients with unstable angina. J Am Coll Cardiol 2000;35:1535–1542.
23.
Biasucci LM, Liuzzo G, Grillo RL: Elevated levels of C-reactive protein at discharge in patient with unstable angina predict recurrent instability. Circulation 1999;99:855–860.
24.
James SK, Armstrong P, Barnathan E: Troponin and C-reactive protein have different relations to subsequent mortality and myocardial infarction after acute coronary syndrome. A GUSTO-IV substudy. J Am Coll Cardiol 2003;41:916–924.
25.
Tomoda, H, Aoki: Prognostic value of C-reactive protein levels within six hours after the onset of acute myocardial infarction. Am Heart J 2000;140:324–328.
26.
De Beer FC, Hind CR, Fox KM, Allan RM, Maseri A, Pepys MB: Measurement of serum C-reactive protein concentration in myocardial ischaemia and infarction. Br Heart J 1982;47:239–243.
27.
Yano K, Suzuki S, HondaY, Yonekura T, Nakashima H, Katayama T: Significance of acute phase inflammatory reactants as an indicator of prognosis after acute myocardial infarction: Which is the most useful predictor? J Cardiol 2003;42:49–56.
28.
De Sutter DJ, De Buyzere MD, Gheeraert P, Van De Wiele C, Voet J, De Pauw M, Dierckx R, De Backer G, Taeymans Y: Fibrinogen and C-reactive protein on admission as markers of final infarct size after primary angioplasty for acute myocardial infarction. Atherosclerosis 2001;157:189–196.
29.
Kinjo K, Sato H, Ohnishi Y, Hishida E, Nakatani D, Mizuno H, Imai K, Nanto S, Naka M, Matsummura Y, Takeda H, Hori M: Impact of high-sensitivity C-reactive protein on predicting long-term mortality of acute myocardial infarction. Am J Cardiol 2003;91:931–935.
30.
Pietila K, Harmoinen A, Simoons ML, Van De Werf F, Verstraete M: Serum C-reactive protein and infarct size in myocardial infarct patients with a closed versus open infarct-related coronary artery after thrombolytic therapy. Eur Heart J 1993;14:915–919.
31.
Kimura K, Kosuge M, Ishikawa T, Shimizu M, Endo T, Hongo Y, Tochikubo O, Umemura S: Relationship between myocardial damage and C reactive protein levels immediately after onset of acute myocardial infarction. Jpn Circ J 2001;65:67–70.
32.
Barrett TD, Hennan JK, Marks RM, Lucchesi BR: C-reactive protein associated increase in myocardial infarct size after ischemia/reperfusion. J Pharmacol Exp Ther 2002;303:1007–1013.
33.
Du Clos TW: Function of C reactive protein. Ann Med 2000;32:274–278.
© 2005 S. Karger AG, Basel
2005
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.