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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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Hauptverfasser: Möckel, Martin (VerfasserIn) , de Boer, Rudolf A. (VerfasserIn) , Slagman, Anna Christine (VerfasserIn) , Haehling, Stephan von (VerfasserIn) , Schou, Morten (VerfasserIn) , Vollert, Jörn Ole (VerfasserIn) , Wiemer, Jan C. (VerfasserIn) , Ebmeyer, Stefan (VerfasserIn) , Martín-Sánchez, F. Javier (VerfasserIn) , Maisel, Alan S. (VerfasserIn) , Giannitsis, Evangelos (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 12 December 2019
In: European journal of heart failure
Year: 2019, Jahrgang: 22, Heft: 2, Pages: 267-275
ISSN:1879-0844
DOI:10.1002/ejhf.1667
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/ejhf.1667
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1667
Volltext
Verfasserangaben: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
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 29.10.2020
Beschreibung:Online Resource
ISSN:1879-0844
DOI:10.1002/ejhf.1667

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