Skip to main content

Procalcitonin Use to Identify the Infected Heart Failure Patient

  • Chapter
Annual Update in Intensive Care and Emergency Medicine 2013

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

Pulmonary infections substantially increase the risk of mortality in patients with heart failure [1]. Commonly seen in the 65–75 year age group, heart failure complicated by ongoing infection (often leading to sepsis) puts a considerable burden on the healthcare system [2]. Improper and untimely management of such patients has driven up healthcare costs significantly. That being the case, patients with heart failure and superimposed infection (especially pneumonia) often present with overlapping symptoms and signs, making it difficult to distinguish using conventional tools, such as radiographic imaging and blood testing. Studies have shown that patients with preexisting heart failure often experience a worsening of their symptoms due to superimposed infection [3, 4]. Pulmonary infections such as pneumonia have been shown to suppress myocardial function, initiate inflammatory hormone release and worsen heart failure [4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McMurray JJV, Adamopoulos S, Anker SD et al (2012) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The task force for the diagnosis and treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 33:1787–1847

    Article  Google Scholar 

  2. Corrales-Medina VF, Musher DM, Wells GA et al (2012) Cardiac Complications in Patients With Community-Acquired Pneumonia-Incidence, Timing, Risk-Factors, and Association With Short-Term Mortality. Circulation 125:773–781

    Article  PubMed  Google Scholar 

  3. Thomsen RW, Kasatpibal N, Riis A et al (2008) The impact of pre-existing heart failure on pneumonia prognosis: Population based cohort study. J Gen Intern Med 23:1407–1413

    Article  PubMed  Google Scholar 

  4. Musher DM, Rueda AM, Kaka AS, Mapara SM (2007) The association between pneumococcal pneumonia and acute cardiac events. Clin Infect Dis 45:158–165

    Article  PubMed  Google Scholar 

  5. Assicot M, Gendrel D, Carsin H et al (1993) High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 341:515–518

    Article  PubMed  CAS  Google Scholar 

  6. Meisner M, Heide A, Schmidt J (2006) Correlation of procalcitonin and C-reactive protein to inflammation, complications, and outcome during the intensive care unit course of multiple-trauma patients. Crit Care 10:R1

    Article  PubMed  Google Scholar 

  7. Christ-Crain M, Stolz D, Bingisser R et al (2006) Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med 174:84–93

    Article  PubMed  CAS  Google Scholar 

  8. Nijsten M, Olinga P, Hauw TT et al (2000) Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Crit Care Med 28:458–461

    Article  PubMed  CAS  Google Scholar 

  9. Maisel A, Neath SX, Landsberg J et al (2012) Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnea: results from the BACH (Biomarkers in Acute Heart Failure) trial. Eur J Heart Fail 14:278–286

    Article  PubMed  CAS  Google Scholar 

  10. Roger VL, Go AS, Lloyd-Jones DM et al (2011) Heart disease and stroke statistics-2011 update A report from the American Heart Association. Circulation 123:e18–e209

    Article  PubMed  Google Scholar 

  11. Weintraub NL, Collins SP, Pang PS et al (2010) Acute heart failure syndromes: emergency department presentation, treatment, and disposition: Current approaches and future aims. Circulation 122:1975–1996

    Article  PubMed  Google Scholar 

  12. Follath F, Delgado JF, Yilmaz MB et al (2011) Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). Intensive Care Med 37:619–626

    Article  PubMed  CAS  Google Scholar 

  13. Arnaudis B, Lairez O, Escamilla R et al (2011) Impact of chronic obstructive pulmonary disease severity on symptoms and prognosis in patients with systolic heart failure. Clin Res Cardiol 101:717–726

    Article  Google Scholar 

  14. Perry TW, Pugh MJV, Waterer GW et al (2011) Incidence of cardiovascular events following hospital admission for pneumonia. Am J Med 124:244–251

    Article  PubMed  Google Scholar 

  15. Corrales-Medina VF, Suh KN, Rose G et al (2011) Cardiac complications in patients with community-acquired pneumonia: A systematic review and meta-analysis of observational studies. PLoS Med 8:e1001048

    Article  PubMed  Google Scholar 

  16. Fillon S, Soulis K, Rajasekaran S et al (2006) Platelet-activating factor receptor and innate immunity: Uptake of gram-positive bacterial cell wall into host cells and cell-specific pathophysiology. J Immunol 177:6182–6191

    PubMed  CAS  Google Scholar 

  17. Christ-Crain M, Muller B (2007) Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators. Eur Respir J 30:556–573

    Article  PubMed  CAS  Google Scholar 

  18. Muller F, Christ-Crain M, Bregenzer T et al (2010) Procalcitonin levels predict bacteremia in patients with community-acquired pneumonia. Chest 138:121–129

    Article  PubMed  CAS  Google Scholar 

  19. Russworm S, Wiederhold M, Oberhoffer M et al (1999) Molecular Aspects and Natural Source of Procalcitonin. Clin Chem Lab Med 37:789–797

    Google Scholar 

  20. Ittner L, Born W, Rau B et al (2002) Circulating procalcitonin and cleavage products in septicemia compared with medullary thyroid carcinoma. Eur J Endocrinol 147:727–731

    Article  PubMed  CAS  Google Scholar 

  21. Meisner M (2007) Pathobiochemistry and clinical use of procalcitonin. Clin Chim Acta 323:17–29

    Article  Google Scholar 

  22. Carrol ED, Thomson APJ, Hart CA (2002) Procalcitonin as a marker of sepsis. Int J Antimicrob Agents 20:1–9

    Article  PubMed  CAS  Google Scholar 

  23. Linscheid P, Seboek D, Schaer DJ et al (2004) Expression and secretion of procalcitonin and calcitonin gene-related peptide by adherent monocytes and by nacrophage-activated adipocytes. Crit Care Med 32:1715–1721

    Article  PubMed  CAS  Google Scholar 

  24. Jin M, Khan AI (2009) Procalcitonin: Uses in the clinical laboratory for the diagnosis of sepsis. Lab Med 41:173–177

    Article  Google Scholar 

  25. Choudhary R, Gopal D, Kipper B et al (2012) Cardiorenal biomarkers in acute heart failure. J Geriatr Cardiol 9:E1–E13

    Article  Google Scholar 

  26. Mueller C, Laule-Kilian K, Frana B et al (2006) Use of B-type natriuretic peptide in the management of acute dyspnea in patients with pulmonary disease. Am Heart J 151:471–477

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Choudhary .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Choudhary, R., Maisel, A.S. (2013). Procalcitonin Use to Identify the Infected Heart Failure Patient. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2013. Annual Update in Intensive Care and Emergency Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35109-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35109-9_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35108-2

  • Online ISBN: 978-3-642-35109-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics