Procalcitonin in acute myocardial infarction.
OBJECTIVE
Procalcitonin (PCT) is released in severe bacterial infections, sepsis and in infection independent cases such as major surgery, multiple trauma, cardiogenic shock, burns, resuscitation, and after cardiac surgery. The aim of this study was to determine the levels and the kinetics of PCT in AMI and to investigate their possible correlation with the release of IL-6 and CRP. DESIGN-PATIENTS: The study included 60 patients (47 men, 63.2+/-14.8 years) with the diagnosis of AMI at admission. In all patients, serum levels of PCT, IL-6, CK-MB, TnI and CRP were measured at admission, at 3, 6, 12, 24, 48 and 72 h and at the seventh day.


RESULTS
PCT was elevated in all patients with AMI. It was initially detected in serum approximately 2-3 h after the onset of the symptoms. The median value at admission was 1.3 ng/ml (95% CI: 0.89 to 1.80). The value of PCT showed an increase and reached a plateau after 12-24 h. The median value at 24 h was 3.57 ng/ml (95% CI: 2.89 to 4.55). PCT values fell to baseline (<0.5 ng/ml) by the seventh day. PCT was detected in serum earlier than CK-MB or TnI in 56 of the 60 patients (93.3%). The kinetics of PCT was similar to those of CK-MB and TnI. The maximal values of PCT were positively correlated with the maximal values of IL-6 (r = 0.59, P = 0.00) and of CRP (r = 0.65, P = 0.001). The maximal values of IL-6 were positively correlated with max CRP (r = 0.35, P = 0.045).


CONCLUSIONS
PCT could be considered as a novel sensitive myocardial index. Its release in AMI is probably due to the inflammatory process that occurs during AMI.
Kafkas
Nikolaos
N
Cardiology Department of General Hospital KAT, Athens, Greece. kafkasncard@yahoo.gr
Venetsanou
Kiriaki
K
Patsilinakos
Sotirios
S
Voudris
Vasilios
V
Antonatos
Dionisios
D
Kelesidis
Kostas
K
Baltopoulos
George
G
Maniatis
Peter
P
Cokkinos
Dennis V
DV
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood* / Q000493:pharmacokinetics; D015740:Calcitonin Gene-Related Peptide; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000097:blood* / Q000493:pharmacokinetics; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011498:Protein Precursors / Q000097:blood* / Q000493:pharmacokinetics; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; C000606589:CALCA protein, human; D006023:Glycoproteins; D015850:Interleukin-6; D011498:Protein Precursors; D019210:Troponin I; D002116:Calcitonin; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form; D015740:Calcitonin Gene-Related Peptide