Methods: A prospective observational study was conducted at Assaf Harofeh Medical Center, Israel. Serum PCT was collected within 48 hours from patients presenting with AMI. Demographic, clinical, and laboratory data, were collected prospectively. Two experienced Infectious Diseases (ID) specialists who were blinded to the PCT results, independently determined the gold standard for infection in every patient. By utilizing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve (AUC), the performance of PCT, fever, white-blood cells (WBC) count and C - reactive protein (CRP) for infection diagnosis was calculated.
Results: The analysis included 230 AMI patients (age 63.0±13.0 years), of which 36 (15.6%) were determined to be infected. The best cut-off for PCT as a differentiating marker between infected and non-infected patients was achieved at 0.09ng/dl (sensitivity 94.4%, specificity 85.1%, AUC ROC 0.94). This test outperformed CRP, WBC, and fever, for infection diagnosis (figure).
Conclusion: PCT should be utilized for ruling out infection in AMI patients by utilizing serum PCT>0.09ng/dl (i.e., ≥0.1ng/dl) as a cut-off.
D. Marchaim, None
H. Segaloff, None
R. Zaidenstein, None
S. Minha, None