Procalcitonin in patients with acute coronary syndromes and cardiogenic shock submitted to percutaneous coronary intervention

Claudio Picariello, Chiara Lazzeri, Marco Chiostri, Gianfranco Gensini, Serafina Valente

Research output: Contribution to journalArticle

Abstract

Procalcitonin (PCT) is known to be a biological diagnostic marker for severe sepsis, or septic shock in critically ill patients. There are still contrasting data about a role of procalcitonin in patients with acute myocardial infarction or cardiogenic shock, and in those with acute coronary syndromes, that is, non-ST-elevation myocardial infarction or unstable angina. We evaluated plasma levels of procalcitonin and C-reactive protein (CRP) in 52 patients admitted to our intensive cardiac care unit (ICCU): 14 patients with cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI), 15 patients with uncomplicated ST-elevation myocardial infarction (STEMI), and 24 with non-ST-elevation myocardial infarction or unstable angina (NSTEMI/UA). In all patients, infective processes were excluded. Procalcitonin values were significantly higher in CS patients with respect to the other two subgroups (P <0.001, P <0.001) while CRP levels were higher than NSTEMI/UA patients (P <0.001) but not with respect to STEMI patients (P = 0.063). No correlations were found in cardiogenic shock patients between CRP and PCT values (R = 0.02; P = 0.762, ns). Procalcitonin levels measured on ICCU admission are significantly higher in patients with cardiogenic shock following the acute myocardial infarction, and they are not correlated with those of CRP. The degree of myocardial ischemia (clinically indicated by the whole spectrum of ACS, from unstable angina to cardiogenic shock ST-elevation following myocardial infarction) and the related inflammatory-induced response are better reflected by CRP (which was positive in most acute cardiac care patients of all our subgroups), than by PCT which seems more reflective of a higher degree of inflammatory activation, being positive only in all CS patients.

Original languageEnglish
Pages (from-to)403-408
Number of pages6
JournalInternal and Emergency Medicine
Volume4
Issue number5
DOIs
Publication statusPublished - Sep 2009

Keywords

  • Acute coronary syndromes
  • Acute myocardial infarction
  • Cardiogenic shock
  • Procalcitonin

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

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