International Journal of Cardiovascular Sciences. 31/Mar/2025;38:e20230144.

Procalcitonin and D-dimer in Predicting the Severity of Congestive Heart Failure

Bryan Gervais de Liyis , Jane Carissa Sutedja , I Gede Krisna Arim Sadeva , Viona Mareska , Albert Salim , George David, Made Favian Budi Gunawan , Jocelin Nathaniela , Desak Made Wihandani , Bagus Ari Pradnyana Dwi Sutanegara

DOI: 10.36660/ijcs.20230144

This Original Article is referred by the Editorial "Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?".

Abstract

Background:

Congestive heart failure (CHF) is an intricate clinical syndrome that significantly contributes to morbidity and mortality. Despite extensive advancements, research on markers of severity in CHF remains scarce.

Objectives:

This study aims to evaluate procalcitonin (PCT) and D-dimer as severity predictors in CHF.

Methods:

CHF patients were included in this retrospective single-center study between January to December 2022. The population group was randomized and classified as stages I to IV based on the New York Heart Association (NYHA) functional classification system. Mean differences and multivariate analysis were performed with a statistical significance at p < 0.05.

Results:

A total of 72 CHF patients were included in the study. The correlation analysis revealed that PCT (p ≤ 0.001), D-dimer (p ≤ 0.001), and systolic blood pressure (SBP) (p = 0.005) were all found to be correlated to the CHF stages. In the analysis of mean differences, PCT (p < 0.001) and D-dimer (p < 0.001) showed significant variation across the CHF stages. The optimal PCT and D-dimer cut-off values were 1.190 ng/mL and 2.110 ng/mL respectively. Conversely, the area under the receiver operating characteristic (ROC) curve was significant for both PCT (Area Under the Curve [AUC]: 0.962; 95% CI: 0.921-1.000; p < 0.001) and D-dimer (AUC: 0.929; 95% CI: 0.868-0.989; p < 0.001). Meanwhile, through multivariate analysis, D-dimer is significantly correlated with the various CHF stages (95% CI: 0.034-0.101, p < 0.001) but not for PCT (95% CI: 0.009–0.017, p = 0.561).

Conclusion:

A significant association between D-dimer levels and CHF stages was found, suggesting the potential of D-dimer as a valuable marker of severity in CHF patients.