title: Kinetics of procalcitonin in cardiogenic shock and in septic shock. Preliminary data.
abstract: BACKGROUND
  In cardiac acute patients, data on procalcitonin (PCT) are controversial and the clinical interpretation of absolute PCT values represents a major challenge since they may be influenced by several factors. No data are so far available on the dynamics of PCT levels in patients with cardiogenic shock.
  
  
  OBJECTIVE
  to evaluate the serum evolution of PCT during intensive cardiac care unit (ICCU) staying in a group of 24 patients with cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous intervention (PCI) with no laboratory or clinical sign of infection. Furthermore we assessed the kinetics of PCT in a series of 24 patients with septic shock.
  
  
  RESULTS
  In septic shock, no significant difference was detectable in PCT kinetics between survivors (R2 = 0.90; P = 0.051) and non-survivors (R2 = 0.63; P = 0.204). In cardiogenic shock, survivors exhibited a significant reduction in PCT values (R2 = 0.94; P = 0.032) while non survivors did not (R2 = 0.68; P = 0.178).
  
  
  CONCLUSIONS
  differently from septic shock, cardiogenic shock following STEMI was associated with heterogeneous patterns of temporal PCT variations since only patients who survived exhibited a significant PCT reduction during ICCU stay. Our findings support the contention that the 'dynamic' approach may be more reliable that the static one especially in cardiogenic shock.
authors.affiliation: Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. claudx@hotmail.com
authors.forename: Claudio
authors.initials: C
authors.lastname: Picariello
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.forename: Paola
authors.initials: P
authors.lastname: Attanà
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D011498:Protein Precursors / Q000097:blood*; D012770:Shock, Cardiogenic / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis*; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide