Fever in myocardial infarction: is it still common, is it still predictive?

BACKGROUND: Before introduction of reperfusion therapy, fever was frequently observed in patients with acute myocardial infarction (AMI). Little is known about this symptom during the widespread use of primary percutaneous coronary intervention (pPCI). The aim of this study was to assess, whether body temperature is a predictor of impaired left ventricular systolic function in patients with AMI.

METHODS: Our cohort included 171 patients (48 women) aged 57 (51-67) years, admitted due to the first AMI with ST elevation treated with successful pPCI. Standard body temperature measurements were performed twice a day. Left ventricular function was assessed by echocardiography using the wall motion score index (WMSI) and ejection fraction (EF). The following inflammatory response markers were determined on admission: C-reactive protein, fibrinogen and white blood cell count.

RESULTS: Within 48 h of observation the median (1(st); 3(rd) quartiles) peak body temperature was 37.0°C (36.7-37.2°C). A temperature above 37.5°C was observed only in 17 (10%) patients. There was no significant correlation between peak body temperature and any of the determined inflammatory response markers. WMSI was assessed at 1.3 (1.1-1.6), whereas EF at 56% (49-62%). There was no significant correlation between the left ventricular function and peak body temperature or determined markers of inflammation.

CONCLUSIONS: In the era of pPCI and aggressive antiplatelet treatment, fever is not a common symptom associated with uncomplicated AMI and thus not correlated with left ventricular function and markers of inflammation.