Association of low body temperature and poor outcomes in patients admitted with worsening heart failure: a substudy of the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial

作者：Payvar Saeed; Spertus John A; Miller Alan B; Casscells S Ward; Pang Peter S; Zannad Faiez; Swedberg Karl; Maggioni Aldo P; Reid Kimberly J; Gheorghiade Mihai^*

来源：European Journal of Heart Failure, 2013, 15(12): 1382-1389.

DOI：10.1093/eurjhf/hft113

• Heart Failure
• Prognosis
• Body temperature

Risk stratification in patients admitted with worsening heart failure (HF) is essential for tailoring therapy and counselling. Risk models are available but rarely used, in part because many require laboratory and imaging results that are not routinely available. Body temperature is associated with prognosis in other illnesses, and we hypothesized that low body temperature would be associated with worse outcomes in patients admitted with worsening HF. %26lt;br%26gt;The Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial was an event-driven, randomized, double-blind, placebo-controlled study of tolvaptan in 4133 patients hospitalized for worsening HF with an EF 40. Co-primary endpoints were all-cause mortality and cardiovascular (CV) death or HF rehospitalization. Body temperature was measured orally at randomization and entered in analyses both as a continuous variable and categorized into three groups (36C, 3636.5C, and 36.5C) using Cox regression models. The composite of CV death or HF rehospitalization occurred in 1544 patients within 1 year. For every 1C decrease in body temperature, the risk of adverse outcomes increased by 16 [hazard raio (HR) 1.16, 95 confidence interval (CI) 1.041.28], after adjustment for age, gender, race, systolic blood pressure, EF, blood urea nitrogen, and serum sodium. In fully adjusted analysis, the risk of adverse outcomes in the lowest body temperature group (36C) was 51 higher than that of the index group (36.5C) (HR 1.35, 95 CI 1.151.58). %26lt;br%26gt;Low body temperature is an independent marker of poor cardiovascular outcomes in patients admitted with worsening HF and reduced EF.

• 出版日期2013-12
• 单位西北大学