Procalcitonin and the early diagnosis of infective endocarditis
- PMID: 15066945
- DOI: 10.1161/01.CIR.0000126281.52345.52
Procalcitonin and the early diagnosis of infective endocarditis
Abstract
Background: Variability in the clinical presentation of infective endocarditis (IE) makes the diagnosis a clinical challenge. We hypothesized that serum procalcitonin, a marker of systemic bacterial infection, might be helpful in its diagnosis.
Methods and results: We conducted a prospective cohort study in 67 consecutive patients admitted to the hospital with the suspicion of IE or in whom the suspicion arose during the hospital course. IE was diagnosed by an interdisciplinary team that included an infectious disease specialist and a cardiologist who applied the Duke criteria. IE was confirmed in 21 patients. Procalcitonin was significantly higher in patients with IE (median 6.56 ng/mL) than in those with other final diagnoses (median 0.44 ng/mL, P<0.001). The area under the receiver operating characteristic curve that used procalcitonin to predict IE was 0.856 (95% CI 0.750 to 0.962), compared with 0.657 (95% CI 0.511 to 0.802) for C-reactive protein. The optimum concentration of procalcitonin for the calculation of positive and negative predictive accuracy as obtained from the receiver operating characteristic curve was 2.3 ng/mL. With this cutoff, the test characteristics of procalcitonin were as follows: sensitivity 81%, specificity 85%, negative predictive value 92%, and positive predictive value 72%. Multiple logistic regression analysis revealed that procalcitonin was the only significant independent predictor of IE on admission (OR 1.52, 95% CI 1.07 to 2.15, P=0.018).
Conclusions: Procalcitonin may be a valuable additional diagnostic marker in patients with suspected IE.
Comment in
-
Procalcitonin and infective endocarditis.Circulation. 2004 Apr 13;109(14):e9035. doi: 10.1161/01.CIR.0000128366.92258.DD. Circulation. 2004. PMID: 15078814 No abstract available.
Similar articles
-
Procalcitonin in 759 patients clinically suspected of infective endocarditis.Am J Med. 2010 Dec;123(12):1121-7. doi: 10.1016/j.amjmed.2010.07.018. Epub 2010 Oct 1. Am J Med. 2010. PMID: 20870199
-
What cardiologists do need to know about procalcitonin.Clin Lab. 2005;51(1-2):1-4. Clin Lab. 2005. PMID: 15719698 Review.
-
Procalcitonin and C-reactive protein in infective endocarditis: correlation with etiology and prognosis.Chemotherapy. 2003 May;49(1-2):76-84. doi: 10.1159/000069777. Chemotherapy. 2003. PMID: 12714816 Clinical Trial.
-
Serum procalcitonin as a diagnostic aid in patients with acute bacterial septic arthritis.Int J Rheum Dis. 2015 Mar;18(3):352-9. doi: 10.1111/1756-185X.12496. Epub 2014 Dec 3. Int J Rheum Dis. 2015. PMID: 25469944
-
The diagnostic accuracy of procalcitonin for bacteraemia: a systematic review and meta-analysis.Clin Microbiol Infect. 2015 May;21(5):474-81. doi: 10.1016/j.cmi.2014.12.026. Epub 2015 Jan 14. Clin Microbiol Infect. 2015. PMID: 25726038 Review.
Cited by
-
Role of biomarkers in antimicrobial stewardship: physicians' perspectives.Korean J Intern Med. 2024 May;39(3):413-429. doi: 10.3904/kjim.2023.558. Epub 2024 Apr 30. Korean J Intern Med. 2024. PMID: 38715231 Free PMC article.
-
Novel putative biomarkers for infective endocarditis by serum proteomic analysis: a comprehensive review of literature.Ann Med Surg (Lond). 2023 Sep 1;85(11):5497-5503. doi: 10.1097/MS9.0000000000001249. eCollection 2023 Nov. Ann Med Surg (Lond). 2023. PMID: 37915652 Free PMC article.
-
Exploring the Risk Factors and Possible Role of Calcium in Infective Endocarditis.Diagnostics (Basel). 2023 Jul 17;13(14):2386. doi: 10.3390/diagnostics13142386. Diagnostics (Basel). 2023. PMID: 37510130 Free PMC article. Review.
-
A New Clinical Prediction Rule for Infective Endocarditis in Emergency Department Patients With Fever: Definition and First Validation of the CREED Score.J Am Heart Assoc. 2023 May 2;12(9):e027650. doi: 10.1161/JAHA.122.027650. Epub 2023 Apr 29. J Am Heart Assoc. 2023. PMID: 37119081 Free PMC article.
-
A Review of Novel Cardiac Biomarkers in Acute or Chronic Cardiovascular Diseases: The Role of Soluble ST2 (sST2), Lipoprotein-Associated Phospholipase A2 (Lp-PLA2), Myeloperoxidase (MPO), and Procalcitonin (PCT).Dis Markers. 2021 Aug 9;2021:6258865. doi: 10.1155/2021/6258865. eCollection 2021. Dis Markers. 2021. PMID: 34422136 Free PMC article. Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials