C-reactive protein to distinguish pneumonia from acute decompensated heart failure

Joffe, Erel; Justo, Dan; Mashav, Noa; Swartzon, Michael; Gur, Hanan; Berliner, Shlomo; Paran, Yael

doi:10.1016/j.clinbiochem.2009.08.007

Cited by 21 publications

(19 citation statements)

References 23 publications

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“…In heart failure, baseline CRP levels were slightly elevated due to systemic inflammation and were stimulated in a limited degree due to an episode of acute exacerbation23. In pneumonia, the basal level is low and an infection stimulates rigorous CRP production, with CRP levels reaching a steady state by 48 hours and eventually decreasing once the stimulus has been removed23.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Cardiogenic and Non-Cardiogenic Causes in Cases with Bilateral Chest Infiltrates

Lee

Park

et al. 2013

Tuberc Respir Dis

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BackgroundDifferentiating cardiogenic pulmonary edema from other bilateral lung diseases such as pneumonia is frequently difficult. We conducted a retrospective study to identify predictors for cardiogenic pulmonary edema and non-cardiogenic causes of bilateral lung infiltrates in chest radiographs.MethodsThe study included patients who had newly developed bilateral lung infiltrates in chest radiographs and patients who underwent echocardiography. Cases were divided into two groups based on the echocardiographic findings: the cardiogenic pulmonary edema group and the non-cardiogenic group. Clinical characteristics and basic laboratory findings were analyzed to identify predictors for differential diagnosis between cardiogenic and non-cardiogenic causes of bilateral chest infiltrates.ResultsWe analyzed 110 subjects. Predictors of cardiogenic pulmonary edema were higher brain natriuretic peptide (BNP) levels, lower C-reactive protein (CRP) levels on the day of the event (<7 mg/dL), age over 60 years, history of heart disease, and absence of fever and sputum. CRP on the day of the event was an independent factor to differentiate cardiogenic and non-cardiogenic causes of newly developed bilateral chest infiltrates. Also, the validity was comparable to BNP.ConclusionClinical symptoms (sputum and fever), medical history (dyslipidemia and heart disease), and laboratory findings (BNP and CRP) could be helpful in the differential diagnosis of patients with acute bilateral lung infiltrates in chest radiographs.

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Section: Discussionmentioning

confidence: 99%

Predictors of Cardiogenic and Non-Cardiogenic Causes in Cases with Bilateral Chest Infiltrates

Lee

Park

et al. 2013

Tuberc Respir Dis

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“…19 Furthermore, our findings concur with those of other recent studies showing that CRP can distinguish patients with pneumonia from exacerbation of COPD and heart failure. 37,38 …”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and C-Reactive Protein in Hospitalized Adult Patients With Community-Acquired Pneumonia or Exacerbation of Asthma or COPD

Bafadhel

Clark

Reid

et al. 2011

Chest

154

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Background:Antibiotic overuse in respiratory illness is common and is associated with drug resistance and hospital-acquired infection. Biomarkers that can identify bacterial infections may reduce antibiotic prescription. We aimed to compare the usefulness of the biomarkers procalcitonin and C-reactive protein (CRP) in patients with pneumonia or exacerbations of asthma or COPD.Methods:Patients with a diagnosis of community-acquired pneumonia or exacerbation of asthma or COPD were recruited during the winter months of 2006 to 2008. Demographics, clinical data, and blood samples were collected. Procalcitonin and CRP concentrations were measured from available sera.Results:Sixty-two patients with pneumonia, 96 with asthma, and 161 with COPD were studied. Serum procalcitonin and CRP concentrations were strongly correlated (Spearman rank correlation coefficient [rs] = 0.56, P < .001). Patients with pneumonia had increased procalcitonin and CRP levels (median [interquartile range] 1.27 ng/mL [2.36], 191 mg/L [159]) compared with those with asthma (0.03 ng/mL [0.04], 9 mg/L [21]) and COPD (0.05 ng/mL [0.06], 16 mg/L [34]). The area under the receiver operating characteristic curve (95% CI) for distinguishing between patients with pneumonia (antibiotics required) and exacerbations of asthma (antibiotics not required), for procalcitonin and CRP was 0.93 (0.88-0.98) and 0.96 (0.93-1.00). A CRP value > 48 mg/L had a sensitivity of 91% (95% CI, 80%-97%) and specificity of 93% (95% CI, 86%-98%) for identifying patients with pneumonia.Conclusions:Procalcitonin and CRP levels can both independently distinguish pneumonia from exacerbations of asthma. CRP levels could be used to guide antibiotic therapy and reduce antibiotic overuse in hospitalized patients with acute respiratory illness.

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“…Так, E.Joffe et al на осно вании результатов исследования, посвященного дифференициальной диагностике ВП и острой де компенсации ХСН у данной возрастной категории, несмотря на достоверность различий, не рекоменду ется использование искомого показателя в клини ческой практике вследствие значительной его вари абельности в обеих группах ( [103]. Данный биомаркер может использо ваться для оптимизации режима системной АБТ, а также с целью дифференциальной диагностики ВП и декомпенсации ХСН [100,107].…”

Section: лабораторная диагностикаunclassified

Community-acquired pneumonia in elderly and very elderly patients

Бобылев¹,

Rachina²,

Авдеев³

et al. 2015

Pulʹmonologiâ (Mosk.)

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C-reactive protein to distinguish pneumonia from acute decompensated heart failure

Cited by 21 publications

References 23 publications

Predictors of Cardiogenic and Non-Cardiogenic Causes in Cases with Bilateral Chest Infiltrates

Predictors of Cardiogenic and Non-Cardiogenic Causes in Cases with Bilateral Chest Infiltrates

Procalcitonin and C-Reactive Protein in Hospitalized Adult Patients With Community-Acquired Pneumonia or Exacerbation of Asthma or COPD

Community-acquired pneumonia in elderly and very elderly patients

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