Significance And Main Influence Factors Of Serum Procalcitonin Levels In Congestive Heart Failure Patients Without Infection

Objective:To investigate the significance and main influence factors of serum procalcitonin levels in congestive heart failure patients without infection.Methods:This study selected inpatients in the cardiovascular medicine department of China-Japan Union Hospital from April 2018 to January 2019.The heart failure group included 50 congestive heart failure patients without infection,and the control group included 31 patients without heart failure and infection.Peripheral venous blood was taken in all patients within 24 hours after admission.PCT and other laboratory indexes were tested,such as white blood cell count(WBC),neutrophil count,lymphocyte count,endotoxin,N terminal B-type natriuretic peptide(NT-proBNP),high sensitive myocardial troponin I(hs-cTnI),creatinine,serum sodium,cholinesterase,gamma-glutamine transfer converting enzyme(GGT),serum albumin,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a),etc.The basic information of all patients were collected when admitted to the hospital,such as age,gender,height,weight,history of hypertension,diabetes,smoking,and peripheral edema,heart rate,systolic blood pressure,diastolic blood pressure and left ventricular ejection fraction(LVEF).Software SPSS23.0 was used to compare the difference of serum PCT concentration between the heart failure group and the non-heart failure group,to compare the levels of serum PCT in different severity and causes of heart failure,and to explore the main influence factors of serum PCT levels in patients with heart failure without infection.Results:1.The median serum PCT concentration in congestive heart failure group without infection was 0.075ng/ml,which was higher than that in the non-heart failure group(the median is 0.040ng/ml),and the difference between two groups was statistically significant(P<0.001,Z=-3.664).2.The median serum PCT concentration in the mild to moderate heart failure group(NYHA II,III)was 0.060ng/ml.The median serum PCT concentration in the severe heart failure group(NYHA IV)was 0.095ng/ml.The serum PCT concentration of the severe heart failure group(NYHA IV)was higher than that of the mild and moderate heart failure group(NYHA II,III),and the difference between two groups was statistically significan(P=0.033).3.The median PCT concentration in the heart failure group caused by ischemic cardiomyopathy was 0.080ng/ml.The median PCT concentration in the dilated cardiomyopathy group was 0.065ng/ml.The median PCT concentration in the other heart failure group was 0.080ng/ml.There was no significant difference among the serum PCT levels of these three groups(P=0.530).4.According to the median PCT value of the heart failure group,the heart failure group was divided into two groups(the high level PCT group and the low level PCT group)to compare the clinical data.The results showed that the NLR of the high level PCT group was higher than that of the low level PCT group,and the difference was statistically significant(P=0.007).And the levels of serum sodium,cholinesterase and serum albumin of the high level PCT group were lower than those of the low level PCT group,and the difference was statistically significant(P=0.020,P=0.017,P=0.034).For gender,age,BMI,the prevalence rates of hypertension,the prevalence rates of diabetes,the proportions of previous smoking history,peripheral edema,heart rate,systolic blood pressure,diastolic blood pressure,WBC,endotoxin,NT-proBNP,LVEF value,hs-cTnI,hemoglobin,eGFR,GGT,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,LDL-C,HDL-C and lipoprotein(a),there was no significant difference between the two groups(P>0.05).Multivariate binary logisticregression analysis was conducted using PCT grouping(the high PCT group was assigned a value of "1",while the low PCT group was assigned a value of "0")as dependent variables and NLR,serum sodium,cholinesterase,serum albumin as covariate.The results showed that the NLR and serum sodium were the main influence factors of serum PCT level in congestive heart failure patients without infection.Conciusion:1.Serum PCT level in the congestive heart failure patients without infection were higher than that in the non-infective patients.2.There was no significant difference in the serum PCT levels of patients with heart failure caused by different etiologies.3.The NLR and serum sodium were the main influence factors of serum PCT level in congestive heart failure patients without infection.4.Serum PCT level may help assess the severity of congestive heart failure without infection.