Body temperature, systemic inflammation and risk of adverse events in patients with acute coronary syndromes.

Autor: van der Stouwe JG; University Heart Center, University Hospital Zurich, Zurich, Switzerland.; Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel and University of Basel, Basel, Switzerland., Godly K; University Heart Center, University Hospital Zurich, Zurich, Switzerland., Kraler S; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Department of Cardiology and Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland., Godly J; University Heart Center, University Hospital Zurich, Zurich, Switzerland., Matter CM; University Heart Center, University Hospital Zurich, Zurich, Switzerland., Wenzl FA; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; National Disease Registration and Analysis Service, NHS, London, UK.; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.; Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden., von Eckardstein A; Institute of Clinical Chemistry, University Hospital of Zurich, Zurich, Switzerland., Räber L; Department of Cardiology, Inselspital Bern, Bern, Switzerland., Mach F; Department of Cardiology, University Hospital Geneva, Geneva, Switzerland., Obeid S; Department of Cardiology, Kantonsspital Liestal, Liestal, Switzerland., Templin C; University Heart Center, University Hospital Zurich, Zurich, Switzerland., Lüscher TF; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Royal Brompton and Harefield Hospitals and Imperial College, London, UK.; Cardiovascular Academic Group, Kings College London, London, UK., Niederseer D; University Heart Center, University Hospital Zurich, Zurich, Switzerland.; Hochgebirgsklinik, Medicine Campus Davos, Davos, Switzerland.; Christine Kühne Center for Allergy Research and Education (CK-CARE), Medicine Campus Davos, Davos, Switzerland.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2024 Dec; Vol. 54 (12), pp. e14314. Date of Electronic Publication: 2024 Sep 30.
DOI: 10.1111/eci.14314
Abstrakt: Background: Inflammatory processes can trigger acute coronary syndromes (ACS) which may increase core body temperature (BT), a widely available low-cost marker of systemic inflammation. Herein, we aimed to delineate baseline characteristics of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS) patients stratified by initial BT and to assess its predictive utility towards major adverse cardiovascular events (MACE) after the index ACS.
Methods: From 2012 until 2017, a total of 1044 ACS patients, 517 with STEMI and 527 with NSTE-ACS, were prospectively recruited at the University Hospital Zurich. BT was measured by digital tympanic thermometer along with high-sensitivity C-reactive protein (hs-CRP) and cardiac troponin-T (hs-cTnT) levels prior to coronary angiography. Patients were stratified according to initial BT and uni- and multivariable regression models were fit to assess associations of BT with future MACE risk.
Results: Among patients with STEMI, BT was not predictive of 1-year MACE, but a U-shaped relationship between BT and MACE risk was noted in those with NSTE-ACS (p = .029), translating into a 2.4-fold (HR, 2.44, 95% CI, 1.16-5.16) increased 1-year MACE risk in those with BT >36.8°C (reference: 36.6-36.8°C). Results remained robust in multivariable-adjusted analyses accounting for sex, age, diabetes, renal function and hs-cTnT. However, when introducing hs-CRP, the BT-MACE association did not prevail.
Conclusions: In prospectively recruited patients with ACS, initial BT shows a U-shaped relationship with 1-year MACE risk among those with NSTE-ACS, but not in those with STEMI. BT is a broadly available low-cost marker to identify ACS patients with high inflammatory burden, at high risk for recurrent ischaemic events, and thus potentially suitable for an anti-inflammatory intervention.
Registration: ClinicalTrials.gov Identifier: NCT01000701.
(© 2024 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
Databáze: MEDLINE
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