Prolonged Fever After ST‐Segment Elevation Myocardial Infarction and Long‐Term Cardiac Outcomes

Figures

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  Figure 1. Study flow chart. ACS indicates acute coronary syndrome; CABG, coronary artery bypass grafting; CV, cardiovascular; IABP, intra‐aortic balloon pump; STEMI, ST‐segment elevation myocardial infarction.

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  Figure 2. The time course of inflammation and body temperature after STEMI. A, The time course of body temperature after STEMI. Body temperature was elevated at the peak by an average of 1.6°C from 24 to 48 hours after admission. After the peak, the time course of body temperature was significantly different between patients with and without future cardiac events (P=0.0393). The recovery from fever was blunted in patients with events compared with those without. B, The impact of first‐ and second‐phase fevers on future cardiac events. The risk associated with fever during the second phase of post‐STEMI inflammation for future cardiac events was significant, but the risk associated with the first‐phase fever was not significant. BT indicates body temperature; HR, hazard ratio; STEMI, ST‐segment elevation myocardial infarction.

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  Figure 3. The time course of inflammatory markers after STEMI. Serial changes in the white blood cell count, monocyte count, C‐reactive protein, and body temperature are shown. BT indicates body temperature; CRP, C‐reactive protein; STEMI, ST‐segment elevation myocardial infarction; WBC, white blood cell.

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  Figure 4. The distribution of the maximum body temperature during the second phase of post‐STEMI inflammation. A Max‐BT 4–10d of 37.1°C was the optimal cut‐off value to predict future cardiac events determined by the Youden index. The high BT 4–10d group was defined as patients with a max‐BT 4–10d ≥37.1°C. BT indicates body temperature; STEMI, ST‐segment elevation myocardial infarction.

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  Figure 5. Unadjusted Kaplan–Meier estimates for cardiac events according to the second‐phase fever. Unadjusted Kaplan–Meier estimates are shown for the rate of the primary composite end point (death from cardiovascular causes, acute coronary syndrome, or heart failure) (A through D) according to the prolonged fever from 4 to 10 days after admission. ACS indicates acute coronary syndrome; BT, body temperature; CV, cardiovascular.

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  Figure 6. Unadjusted Kaplan–Meier estimates for cardiac events according to first‐phase fever. A max‐BT 1–3d of 37.9°C was the optimal cut‐off value to predict future cardiac events determined by the Youden index. The high BT 1–3d group was defined as patients with a max‐BT 1–3d ≥37.9°C. Unadjusted Kaplan–Meier estimates are shown for the rate of the primary composite end point (death from cardiovascular causes, acute coronary syndrome, or heart failure) (A through D) according to the high and low max‐BT 1–3d groups. ACS indicates acute coronary syndrome; BT, body temperature; CV, cardiovascular.