Usefulness of Presepsin (sCD14-ST) in diagnosis of Infective Endocarditis - preliminary results of an observational study / Utilitatea presepsinului (sCD14-ST) în Endocardita Infecțioasă –rezultate preliminare ale unui studiu observațional

Background: Soluble CD14 subtype (sCD14-ST), also named presepsin, has been proposed as a novel biomarker for the diagnosis of sepsis. We hypothesized that presepsin value might be helpful in the diagnosis of infective endocarditis (IE).

Material and methods: In this prospective study a total of 29 patients with clinical suspicion of IE were enrolled. The plasma presepsin samples were collected at the admittance in the same time with blood cultures, CRP (C-reactive protein) and routine blood tests. Data about the antibiotic treatment prior to admittance were recorded. The diagnosis of IE was made using the Duke modified criteria. Receiver operating characteristic (ROC) curves analysis and binary logistic regression were performed using SPSS software, version 18. A p value less than 0.05 is considered statistically significant.

Results: Patients were divided in two subgroups: 14 patients with definite IE and 8 with IE - rejected according to the modified Duke criteria. 7 patients with final diagnosis of sepsis were excluded. Presepsin levels in patient with definite IE were significantly higher than in those with rejected IE (p<0.03). The area under the receiver operating characteristic curve (AUC) was 0.781 (95 % confidence interval (CI) 0.590 - 0.973). The threshold value of presepsin in predicting IE was determined to be 345 pg/ml, of which the clinical sensitivity and specificity were 64% and respectively, 88%. The AUC for CRP was 0.656 (95% CI 0.37-0.88).

Conclusion: Presepsin might be a useful additional diagnostic marker in patients with suspected IE. These preliminary results needs confirmation by future studies.