Open AccessSerum procalcitonin and high sensitivity C-reactive protein in distinguishing ADHF and CAP
Author(s) -
Magdy Abdel Hamid Abdel Aziz,
Hussein Heshmat Mohammed,
Amany Atf Elkarim Abou Zaid,
Hebatallah Hany Assal,
Reham Aly Rashad
Publication year - 2014
Publication title -
egyptian journal of chest diseases and tuberculosis/egyptian journal of chest diseases and tuberculosis
Language(s) - English
Resource type - Journals
eISSN - 2090-9950
pISSN - 0422-7638
DOI - 10.1016/j.ejcdt.2014.02.002
Subject(s) - procalcitonin , medicine , acute decompensated heart failure , pneumonia , community acquired pneumonia , heart failure , emergency department , c reactive protein , receiver operating characteristic , gastroenterology , cutoff , bacterial pneumonia , cardiology , sepsis , inflammation , physics , quantum mechanics , psychiatry
BackgroundRapid and accurate diagnosis and management can be lifesaving for patients with acute dyspnea. However, making a differential diagnosis and selecting early treatment for patients with acute dyspnea in the emergency setting are a clinical challenge that requires complex decision-making in order to achieve hemodynamic balance, decrease unnecessary usage of antibiotic therapy, and decrease mortality.AimTo study the efficacy of measuring high sensitivity C-reactive protein (Hs-CRP) and procalcitonin (PCT) levels on admission in differentiating acute decompensated heart failure (ADHF) from community acquired pneumonia (CAP) in patients with acute dyspnea in the emergency setting.MethodsA comparative analytical study of ADHF included CAP patients admitted to the emergency room for acute dyspnea. Patients who qualified the criteria for both pneumonia and heart failure were excluded. Efficacy for Hs-CRP and PCT as a diagnostic markers was evaluated by using receiver operator curves (ROC).ResultsThirty patients with ADHF and 30 patients with CAP were studied. Patients with pneumonia had increased Hs-CRP and PCT levels on admission (mean values were 76.6±41.8mg/L, and 0.95±0.54ng/ml, respectively), compared with those with heart failure (18.53±18.49mg/L, and 0.09±0.03ng/ml, respectively). For differentiating pneumonia from HF, the cutoff value of Hs-CRP was 15mg/L, with sensitivity 96.7% and specificity 70%, while the cutoff value of PCT was 0.2ng/ml with sensitivity 93.3% and specificity 100%.ConclusionProcalcitonin and Hs-CRP levels can both independently distinguish CAP from ADHF in the emergency setting