E-Book 2nd Congress

  • The Role of Procalcitonin in the Diagnosis of Bacterial Pneumonia in Heart Failure Patients
  • Ali Samankan,1,* Niloofar Rashidi,2
    1. Student Research Committee, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
    2. Department of Laboratory Sciences, School of Allied Medical Sciences Iran University of Medical Sciences, Tehran, Iran


  • Introduction: Introduction: Bacterial pneumonia is a common infectious disease mostly caused by Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Legionella pneumophila. It has higher risk by comorbidities such as, chronic obstructive pulmonary (COPD), asthma, and heart failure. Some of its symptoms includes cough, dyspnea, pleuritic pain, abnormal vital signs (e.g., fever, tachycardia). Since the role of biomarkers in the diagnosis of bacterial pneumonia is controversial, it is often difficult to distinguish pneumonia from other diseases that cause shortness of breath. Inflammatory markers, such as procalcitonin (PCT), can help make the diagnosis easier.
  • Methods: Methods: In this review article, the studies conducted using the keywords of procalcitonin, pneumonia, pneumonia biomarkers and Heart failure in the databases PubMed, Science direct, Scopus and Google Scholar.
  • Results: Results: Procalcitonin is one of the most widely used biomarkers for pneumonia. During a bacterial infection, the CALC-1 gene is upregulated, leading to increased production of procalcitonin by innate immune cells such as macrophages. Increased production of procalcitonin usually occurs in the liver, lungs, and intestines. Procalcitonin can be detected within 2-3 hours and its maximum is in 6 hours. Procalcitonin can reduce the use of antibiotics by reducing the duration of the antibiotic course. It is important to note that persistently elevated procalcitonin levels may indicate a complicated course, but there is also the possibility that they may be falsely elevated. In contrast, persistently low levels of procalcitonin can be seen in localized infections (e.g., empyema, abscess).
  • Conclusion: Conclusion: Using procalcitonin as a biomarker, its diagnostic accuracy is high in pneumonia and it can be used as a biomarker. In acute heart failure, PCT showed superior to CRP and WBC to diagnose. In conclusion PCT provide strong and additional information to clinical variables and to the established biomarkers CRP and WBC, for diagnosing pneumonia in patients with acute dyspnea. PCT seems particularly helpful to diagnose pneumonia among patients with concomitant acute HF.
  • Keywords: procalcitonin, pneumonia, pneumonia biomarkers, Heart failure