JACC. Advances · 2025
Fever in Myocardial Infarction-Related Cardiogenic Shock.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pierce Matthew, Adi Abduljabar, Jain Rohit, Calvo Ahmed, Guru Satvinder, Li Shuojohn, Ramsis Ramsis, Mokhtari Moein Bayat, Samdrup Dechen, Yonghang Sapana, Roubin Joshua, Bali Atul D, Fontes Joao D, Griffin Matthew, Alvarez Villela Miguel
Аннотация
BACKGROUND: The role of fever in acute myocardial infarction-related cardiogenic shock (AMI-CS) in the contemporary era is not well described.
OBJECTIVES: The aim of the study was to describe the epidemiology of fever in AMI-CS and its impact on clinical outcomes.
METHODS: Among all AMI-CS patients in the Northwell-Shock registry (n = 1,372), fever was identified via ≥2 temperatures ≥38.0 °C or one ≥38.3 °C. Characteristics, management, and outcomes were compared between patients with and without fever.
RESULTS: Fever occurred in 40% of patients at a median of 2 days [0-6] after admission. Patients with fever were younger, more often male, and had higher shock severity, receiving more invasive treatment. Febrile patients received more antibiotics (84% vs 42%; P < 0.001), yet only 21% had positive microbial cultures. Early fever (<72 hours) was associated with a lower rate of positive cultures (13% vs 24%; P = 0.002). In-hospital mortality was similar between the groups (30% vs 31%; P = 0.78), but patients with fever had longer hospital stays (19 days vs 9 days; P < 0.001) and more discharges to skilled nursing facilities (49% vs 36%; P < 0.001). On multivariable logistic regression, female sex (OR: 1.9; P = 0.001), non-ST-segment elevation myocardial infarction etiology (OR = 1.5; P = 0.047), mechanical ventilation (OR: 2.1; P < 0.001), and acute dialysis (OR: 1.6; P = 0.040) were associated with positive cultures in febrile patients.
CONCLUSIONS: Fever in AMI-CS is common and is associated with greater illness severity but seems to be noninfectious in most cases. Further research should focus on improving antibiotic use in this population.
OBJECTIVES: The aim of the study was to describe the epidemiology of fever in AMI-CS and its impact on clinical outcomes.
METHODS: Among all AMI-CS patients in the Northwell-Shock registry (n = 1,372), fever was identified via ≥2 temperatures ≥38.0 °C or one ≥38.3 °C. Characteristics, management, and outcomes were compared between patients with and without fever.
RESULTS: Fever occurred in 40% of patients at a median of 2 days [0-6] after admission. Patients with fever were younger, more often male, and had higher shock severity, receiving more invasive treatment. Febrile patients received more antibiotics (84% vs 42%; P < 0.001), yet only 21% had positive microbial cultures. Early fever (<72 hours) was associated with a lower rate of positive cultures (13% vs 24%; P = 0.002). In-hospital mortality was similar between the groups (30% vs 31%; P = 0.78), but patients with fever had longer hospital stays (19 days vs 9 days; P < 0.001) and more discharges to skilled nursing facilities (49% vs 36%; P < 0.001). On multivariable logistic regression, female sex (OR: 1.9; P = 0.001), non-ST-segment elevation myocardial infarction etiology (OR = 1.5; P = 0.047), mechanical ventilation (OR: 2.1; P < 0.001), and acute dialysis (OR: 1.6; P = 0.040) were associated with positive cultures in febrile patients.
CONCLUSIONS: Fever in AMI-CS is common and is associated with greater illness severity but seems to be noninfectious in most cases. Further research should focus on improving antibiotic use in this population.