Document Detail


The value of procalcitonin, a novel inflammatory marker, in the diagnosis of myocardial infarction and evaluation of acute coronary syndrome patients.
MedLine Citation:
PMID:  20813483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Procalcitonin is a calcitonin precursor that is used as an inflammatory biomarker in the plasma of patients with sepsis.
OBJECTIVE: The aim of this study was to determine the diagnostic accuracy of emergency department (ED) point-of-care blood procalcitonin testing in identifying myocardial infarction (MI) in patients with chest pain of presumed ischemic origin.
METHODS: Patients over 18 years of age who presented to the ED with MI-typical chest pain of presumed ischemic origin were included in the study. An initial point-of-care blood sample was drawn from each study patient for testing procalcitonin, troponin T, myoglobin, and creatine kinase-MB levels. A second sample was taken 4h after admission for a procalcitonin test. Finally, a 6-h post-admission blood sample was taken to measure troponin T, myoglobin, and creatine kinase-MB levels in each study patient who had an initial negative cardiac marker test.
RESULTS: A total of 1008 patients with chest pain were admitted to the ED during the study period, and a total of 141 patients met study criteria and were entered into the study. ED point-of-care blood procalcitonin testing to identify myocardial infarction in patients with chest pain of presumed ischemic origin had a sensitivity of 38.3% (95% confidence interval [CI] 28.8-47.3%) and a specificity of 77.8% (95% CI 70.0-84.4%), a positive likelihood ratio (LR+) of 1.725 and a negative likelihood ratio (LR-) of 0.792. The 4th hour diagnostic values (sensitivity, specificity, LR+ and LR-) of procalcitonin semi-quantitative (PCT-Q) testing were 90% (95% CI 80.9-95.7%), 59.3% (95% CI 52.5-63.5%), 2.2, and 0.16, respectively.
CONCLUSION: ED point-of-care testing for procalcitonin had poor diagnostic accuracy for predicting myocardial infarction.
Authors:
Firat Bektas; Secgin Soyuncu; Ilker Gunduz; Ibrahim Basarici; Halide Akbas; Cenker Eken
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-02
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  41     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-09     Completed Date:  2012-01-05     Revised Date:  2014-01-14    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-30     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis*
Adult
Aged
Biological Markers / blood
Calcitonin / blood*
Chest Pain / diagnosis
Emergency Service, Hospital
Female
Humans
Inflammation / blood
Male
Middle Aged
Myocardial Infarction / diagnosis*
Point-of-Care Systems / standards
Prospective Studies
Protein Precursors / blood*
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Protein Precursors; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin
Comments/Corrections
Comment In:
J Emerg Med. 2013 Dec;45(6):921-2   [PMID:  24113475 ]

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