Kinetics of procalcitonin in cardiogenic shock and in septic shock. Preliminary data

Background: In cardiac acute patients, data on procalcitonin (PCT) are controversial and the clinical interpretation of absolute PCT values represents a major challenge since they may be influenced by several factors. No data are so far available on the dynamics of PCT levels in patients with cardiogenic shock. Aims: to evaluate the serum evolution of PCT during intensive cardiac care unit (ICCU) staying in a group of 24 patients with cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous intervention (PCI) with no laboratory or clinical sign of infection. Furthermore we assessed the kinetics of PCT in a series of 24 patients with septic shock. Results: In septic shock, no significant difference was detectable in PCT kinetics between survivors (R2 0.90; P 0.051) and non-survivors (R2 0.63; P 0.204). In cardiogenic shock, survivors exhibited a significant reduction in PCT values (R2 0.94; P 0.032) while non survivors did not (R2 0.68; P 0.178). Conclusions: differently from septic shock, cardiogenic shock following STEMI was associated with heterogeneous patterns of temporal PCT variations since only patients who survived exhibited a significant PCT reduction during ICCU stay. Our findings support the contention that the 'dynamic' approach may be more reliable that the static one especially in cardiogenic shock.