Diagnostic value of procalcitonin in patients with infection complicated by heart failure / 中华检验医学杂志

ABSTRACT

Objective To evaluate the diagnostic value of procalcitonin (PCT) in patients with infection complicated by heart failure.Methods A total 2454 patients,which with simple heart failure,simple bacterial infection and bacterial infection complicated with heart failure,from Sun Yat-sen University affiliated zhongshan hospital were enrolled in this case-control study.244 heathly controls were aslo evaluated at the same time.The serum PCT levels in different groups were analyzed by Cobas E601.ROC curve was employed to compare the diagnostic values of PCT between simple heart failure group and infection complicated with heart failure group,and the cutoff value of PCT testing for infection complicated by different grades heart failure was determined.The difference between test groups was analyzed using Kruskal-Walis H method.Results PCT levels in simple heart failure group (3.46 ± 3.07) were significantly higher than those in control group (0.04 ± 0.03) (t =4.262,P ＜ 0.01).Besides,PCT levels in infection complicated by heart failure group(18.18 ± 10.33)were significantly higher than those in simple infection group(8.97 ± 6.20) (t =2.694,P ＜ 0.01).Although PCT could still be a biomarker for diagnosis of bacterial infection in patients with or without heart failure (areas under the ROC curve were 80％,82％,85％,88％,respectively),the positive predictive values of PCT were declined in line with the heart failure degree increasing [z(1,2) =-6.24,P＜0.01; z(l,3) =-4.35,P＜0.01; z(1,4) =-5.19,P＜0.01; z(2,3) =-5.33,P＜0.01;z(2,4) =-2.86,P＜0.05; z(3,4) =-2.46,P＜0.05].There are significant differences between areas under ROC curve [z(1,2) =-2.55,P ＜ 0.05 ; z(1,3) =-5.42,P ＜ 0.01; z(2,3) =-2.90,P ＜ 0.05],and the cutoff values of PCT to identify infection patients complicated with Ⅱ,Ⅲ,Ⅳ degrees heart failure were 0.086,0.192 and 0.657 μg/L,respectively.Conclusion PCT levels were increased in heart failure patients so we should pay more attention to the degree of heart failure and PCT level on patients which suffered both infection and heart failure.