Procalcitonin (PCT) Predicts Worse Outcome in Patients with Chronic Heart Failure with Reduced Ejection Fraction (HFrEF).

J Banach,J Michałkiewicz,L Gackowska,W Gilewski,Ł Wołowiec,D Rogowicz,I Kubiszewska,W Sinkiewicz

doi:10.1155/2018/9542784

J Banach, J Michałkiewicz + Show 6 more

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https://doi.org/10.1155/2018/9542784

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Journal: Disease markers	Publication Date: Aug 28, 2018
Citations: 8	License type: CC BY 4.0

Affiliation: Collegium Medicum in Bydgoszcz

Abstract

Introduction Procalcitonin (PCT) is an excellent marker of sepsis but was not extensively studied in cardiology. The present study investigated PCT plasma concentration in patients with chronic heart failure with reduced ejection fraction (HFrEF) and its prognostic value during 24-month follow-up. Material and Methods Study group consisted of 130 patients with HFrEF (LVEF ≤ 45%) and 32 controls. PCT level was assessed on admission in all patients. Telephone follow-up was performed every three months over a period of 2 years. Endpoints were death of all causes and readmission for HFrEF exacerbation. Results HFrEF patients had significantly higher PCT concentration than controls (166.95 versus 22.15 pg/ml; p < 0.001). Individuals with peripheral oedema had increased PCT comparing to those without oedema (217.07 versus 152.12 pg/ml; p < 0.02). In ROC analysis, PCT turned out to be a valuable diagnostic marker of HFrEF (AUC 0.91; p < 0.001). Kaplan-Meier survival curves revealed that patients with PCT in the 4th quartile had significantly lower probability of survival than those with PCT in the 1st and 2nd quartiles. In univariate, but not multivariate, analysis, procalcitonin turned out to be a significant predictor of death during 24-month follow-up. (HR 1.002; 95% CI 1.000–1.003; p < 0.03). Conclusions Elevated PCT concentration may serve as another predictor of worse outcome in patients with HFrEF.

Highlights

Procalcitonin (PCT) is an excellent marker of sepsis but was not extensively studied in cardiology
The study group consisted of 130 consecutive patients admitted to the university hospital department of cardiology with chronic heart failure with reduced ejection fraction
Low-output states were excluded from the study as in our opinion in initial stages it is difficult to make a clear distinction between plain HF exacerbation with hypotension and developing cardiogenic shock being a classical form of acute heart failure

Summary

Introduction

Procalcitonin (PCT) is an excellent marker of sepsis but was not extensively studied in cardiology. The present study investigated PCT plasma concentration in patients with chronic heart failure with reduced ejection fraction (HFrEF) and its prognostic value during 24-month follow-up. HFrEF patients had significantly higher PCT concentration than controls (166.95 versus 22.15 pg/ml; p < 0 001). In ROC analysis, PCT turned out to be a valuable diagnostic marker of HFrEF (AUC 0.91; p < 0 001). Elevated PCT concentration may serve as another predictor of worse outcome in patients with HFrEF. Increased concentration of procalcitonin was reported in infectious diseases and in ischemic stroke [10], in lupus exacerbation [11], and in patients with medullary thyroid carcinoma [12]. Procalcitonin is a valuable tool in differentiating patients presenting with acute dyspnoea into those with acute heart failure and those with pneumonia [13]

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