University Heart Center, University Hospital Zurich, Zurich, Switzerland.
Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel and University of Basel, Basel, Switzerland.
Eur J Clin Invest. 2024 Dec;54(12):e14314. doi: 10.1111/eci.14314. Epub 2024 Sep 30.
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.
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.
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.
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.
ClinicalTrials.gov Identifier: NCT01000701.
炎症过程可引发急性冠状动脉综合征（ACS），这可能会导致核心体温（BT）升高，BT 是一种广泛可用的、低成本的全身炎症标志物。在此，我们旨在描述根据初始 BT 分层的 ST 段抬高型心肌梗死（STEMI）和非 ST 段抬高型 ACS（NSTE-ACS）患者的基线特征，并评估其对 ACS 后主要不良心血管事件（MACE）的预测效用。
2012 年至 2017 年，共前瞻性招募了 1044 例 ACS 患者，其中 517 例为 STEMI，527 例为 NSTE-ACS。在进行冠状动脉造影之前，使用数字鼓膜温度计测量 BT 以及高敏 C 反应蛋白（hs-CRP）和心脏肌钙蛋白-T（hs-cTnT）水平。根据初始 BT 将患者分层，并拟合单变量和多变量回归模型以评估 BT 与未来 MACE 风险的相关性。
在 STEMI 患者中，BT 不能预测 1 年 MACE，但在 NSTE-ACS 患者中观察到 BT 与 MACE 风险之间呈 U 形关系（p=0.029），这意味着 BT >36.8°C（参考值：36.6-36.8°C）的患者 1 年 MACE 风险增加 2.4 倍（HR，2.44，95%CI，1.16-5.16）。在多变量调整分析中，考虑到性别、年龄、糖尿病、肾功能和 hs-cTnT 后，结果仍然稳健。然而，当引入 hs-CRP 时，BT-MACE 相关性不再成立。
在前瞻性招募的 ACS 患者中，初始 BT 与 NSTE-ACS 患者 1 年 MACE 风险呈 U 形关系，但在 STEMI 患者中则没有。BT 是一种广泛可用的低成本标志物，可用于识别炎症负担高、复发性缺血事件风险高的 ACS 患者，因此可能适合进行抗炎干预。
ClinicalTrials.gov 标识符：NCT01000701。
