Improve management of acute heart failure with ProcAlCiTonin in EUrope: results of the randomized clinical trial IMPACT EU Biomarkers in Cardiology (BIC) 18
AIM: To determine whether initiation of antibiotic therapy (ABX) by procalcitonin (PCT) within 8 h of admission in patients presenting to the emergency department with symptoms and signs of acute heart failure (AHF) and elevated natriuretic peptides would improve clinical outcomes. METHODS AND RESUL...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
12 December 2019
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| In: |
European journal of heart failure
Year: 2019, Volume: 22, Issue: 2, Pages: 267-275 |
| ISSN: | 1879-0844 |
| DOI: | 10.1002/ejhf.1667 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/ejhf.1667 Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1667 
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| Author Notes: | Martin Möckel, Rudolf A. de Boer, Anna Christine Slagman, Stephan von Haehling, Morten Schou, Jörn Ole Vollert, Jan C. Wiemer, Stefan Ebmeyer, F. Javier Martín-Sánchez, Alan S. Maisel, and Evangelos Giannitsis |
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| 245 | 1 | 0 | |a Improve management of acute heart failure with ProcAlCiTonin in EUrope |b results of the randomized clinical trial IMPACT EU Biomarkers in Cardiology (BIC) 18 |c Martin Möckel, Rudolf A. de Boer, Anna Christine Slagman, Stephan von Haehling, Morten Schou, Jörn Ole Vollert, Jan C. Wiemer, Stefan Ebmeyer, F. Javier Martín-Sánchez, Alan S. Maisel, and Evangelos Giannitsis |
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| 520 | |a AIM: To determine whether initiation of antibiotic therapy (ABX) by procalcitonin (PCT) within 8 h of admission in patients presenting to the emergency department with symptoms and signs of acute heart failure (AHF) and elevated natriuretic peptides would improve clinical outcomes. METHODS AND RESULTS: The study was a randomized multicentre clinical trial conducted at 16 sites in Europe. Patients were randomized to either a PCT-guided strategy or standard care. Patients with PCT-guided strategy (n = 370) had ABX initiated if PCT was > 0.2 μg/L. Patients with standard care (n = 372) had AHF care in accordance with published guidelines without PCT. The primary endpoint was 90-day all-cause mortality. Pre-specified secondary endpoints included 30-day all-cause mortality and readmission and rate of pneumonia. The Data Safety and Review Committee recommended stopping the study for futility when 762 of the planned 792 patients had been enrolled. A total of 742 patients could be analysed. Patients were elderly (median age: 77 years), 38% were women, and had typical signs and symptoms of AHF. All-cause mortality at 90 days was 10.3% in the PCT-guided group vs. 8.2% in standard care (P = 0.316). Thirty-day readmission was significantly higher in the PCT-guided group vs. standard care but the difference vanished until day 90. The rate of pneumonia was overall low (7.5%) and not different between groups. CONCLUSIONS: In patients with AHF, a strategy of PCT-guided initiation of ABX was not more effective than a standard care strategy in improving clinical outcomes. | ||
| 534 | |c 2019 | ||
| 650 | 4 | |a Acute heart failure | |
| 650 | 4 | |a Antibiotic therapy | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Natriuretic peptides | |
| 650 | 4 | |a Procalcitonin | |
| 700 | 1 | |a de Boer, Rudolf A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Slagman, Anna Christine |e VerfasserIn |4 aut | |
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