Procalcitonin: A new biomarker for the cardiologist

•The inflammatory blood marker procalcitonin (PCT) aids in the diagnosis of bacterial infection and appropriate antibiotic use•The potential benefits of PCT testing in patients with acute cardiovascular disorders are being actively investigated•PCT provides information on the likelihood of an infectious cause in patients presenting with acute cardiovascular symptoms•PCT also provides prognostic information and correlates with clinical outcomes in different cardiovascular disorders•Prospective interventional trials may highlight the utility of PCT as a biomarker in managing acute cardiovascular disorders

Due to its high accuracy for the diagnosis of bacterial infections, the inflammatory biomarker procalcitonin (PCT) is increasingly being used in patients with suspected infection. In patients with infections of the respiratory tract, it allows rapid rule out of bacterial etiology and facilitates decisions pertaining to antibiotic management. A growing body of evidence also supports PCT testing in patients with cardiovascular disorders including, but not limited to, those with shortness of breath, possible heart failure, suspected endocarditis, and acute coronary syndromes. In these clinical situations, PCT may provide diagnostic information on the likelihood of an infectious cause in cardiovascular patients presenting with acute symptoms such as dyspnea. It may also have a prognostic value that correlates with clinical outcome and can potentially guide drug therapy. This narrative review summarizes current concepts and evidence from the published literature on the strengths and limitations of PCT as a biomarker, with a focus on patients with a variety of cardiovascular disorders.