LAUSR

Abstract Background Significant proportion of patients with acute myocardial infarction (AMI) also present with systemic inflammatory response syndrome (SIRS). Thus it is difficult to determine in certain situations, whether empiric antibiotic treatment is warranted. Serum procalcitonin (PCT) is known to be elevated in bacterial infections, but its performances in predicting bacterial infection among patients with AMI, who might benefit from appropriate empiric management, is unknown. Methods A prospective observational study was conducted at Assaf Harofeh Medical Center, Israel. Serum PCT was collected within 48 hours from patients presenting with AMI. Demographic, clinical, and laboratory data, were collected prospectively. Two experienced Infectious Diseases (ID) specialists who were blinded to the PCT results, independently determined the gold standard for infection in every patient. By utilizing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve (AUC), the performance of PCT, fever, white-blood cells (WBC) count and C-reactive protein (CRP) for infection diagnosis was calculated. Results The analysis included 230 AMI patients (age 63.0 ± 13.0 years), of which 36 (15.6%) were determined to be infected. The best cutoff for PCT as a differentiating marker between infected and non-infected patients was achieved at 0.09ng/dl (sensitivity 94.4%, specificity 85.1%, AUC ROC 0.94). This test outperformed CRP, WBC, and fever, for infection diagnosis (figure). Conclusion PCT should be utilized for ruling out infection in AMI patients by utilizing serum PCT>0.09ng/dl (i.e., ≥0.1ng/dl) as a cutoff. Disclosures All authors: No reported disclosures.