Procalcitonin and long-term prognosis after an admission for acute heart failure
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Scholar |
Otros documentos de la autoría: Villanueva, María Pilar; Mollar, Anna; Palau, Patricia; Carratalá, Arturo; Núñez, Eduardo; Santas, Enrique; Bodí, Vicent; Chorro, Francisco J.; Miñana, Gema; Blasco, María L.; Sanchis, Juan; Núñez, Julio
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http://dx.doi.org/10.1016/j.ejim.2014.12.009 |
Metadatos
Título
Procalcitonin and long-term prognosis after an admission for acute heart failureAutoría
Fecha de publicación
2015Editor
ElsevierISSN
0953-6205; 1879-0828Cita bibliográfica
VILLANUEVA, Maria Pilar, et al. Procalcitonin and long-term prognosis after an admission for acute heart failure. European journal of internal medicine, 2015, vol. 26, no 1, p. 42-48.Tipo de documento
info:eu-repo/semantics/articleVersión de la editorial
http://www.sciencedirect.com/science/article/pii/S095362051400363XVersión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
Background
Traditionally, procalcitonin (PCT) is considered a diagnostic marker of bacterial infections. However, slightly elevated levels of PCT have also been found in patients with heart failure. In this context, ... [+]
Background
Traditionally, procalcitonin (PCT) is considered a diagnostic marker of bacterial infections. However, slightly elevated levels of PCT have also been found in patients with heart failure. In this context, it has been suggested that PCT may serve as a proxy for underrecognized infection, endotoxemia, or heightened proinflammatory activity. Nevertheless, the clinical utility of PCT in this setting is scarce. We aimed to evaluate the association between PCT and the risk of long-term outcomes.
Methods and results
We measured at admission PCT of 261 consecutive patients admitted for acute heart failure (AHF) after excluding active infection. Cox and negative binomial regression methods were used to evaluate the association between PCT and the risk of death and recurrent rehospitalizations, respectively. At a median follow-up of 2 years (IQR: 1.0–2.8), 108 deaths, 170 all-cause rehospitalizations and 96 AHF-rehospitalizations were registered. In an adjusted analysis, including well-established risk factors such as natriuretic peptides and indices of renal function, the logarithm of PCT was associated with a higher risk of death (HR = 1.43, CI 95%: 1.12–1.82; p = 0.004), all-cause rehospitalizations (IRR = 1.22, CI 95% 1.02–1.44; p = 0.025) and AHF-rehospitalizations (IRR = 1.28, CI 95%: 1.02–1.61; p = 0.032). The association with these endpoints persisted after adjustment for other inflammatory biomarkers such as white blood cells, C-reactive protein and interleukins.
Conclusion
In patients with AHF and no evidence of infection, PCT was independently and positively associated with the risk of long-term death and recurrent rehospitalizations. [-]
Publicado en
European Journal of Internal Medicine Volume 26, Issue 1, January 2015, Pages 42–48Derechos de acceso
Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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info:eu-repo/semantics/restrictedAccess
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