A STUDY OF SERUM PRO-CALCITONIN LEVELS AS A PROGNOSTIC MARKER IN PATIENTS ADMITTED WITH ST ELEVATION MYOCARDIAL INFARCTION

Abstract

BACKGROUND- Acute myocardial infarction (AMI) remains a major cause of morbidity and mortality worldwide. Initial evidence suggests that Procalcitonin (PCT) can act as a potential blood based biomarker in AMI. Therefore, it may be helpful in prognostication and risk-stratication of patients with STelevation myocardial infarction (STEMI) and help us to predict the risk of cardiovascular complications and outcome. AIM- To study the association of PCTlevels at the time of admission with incidence of cardiovascular complications in terms of cardiogenic shock, heart failure, arrhythmia and death in patients admitted with STEMI. METHOD- Aprospective observational study was conducted in a tertiary care centre of India. Patients diagnosed with STEMI were enrolled in the study after making the necessary exclusions. The PCT levels were checked at the time of admission along with electrocardiography (ECG), Echocardiography, Troponin I ,total leukocyte count (TLC), blood urea, creatinine and liver function test (LFT). Patients were followed till discharge / death and outcomes were recorded. RESULT- Two hundred and fty patients were included in the study (57.60 % males, mean age- 59.77±13.63 years). High PCT levels (>0.10 ng/ml) were signicantly associated with cardiovascular complications in terms of cardiogenic shock, arrhythmia's, heart failure and signicant left ventricular dysfunction. Raised PCTlevel was found to be a good predictor of mortality (relative risk =10.51). CONCLUSION- Raised PCT levels were associated with higher cardiovascular complications and mortality in patients with STEMI. PCT levels at the time of admission may be useful as a biomarker in prognostication and risk stratication of STEMI patients.