SPC365

Diagnostic Performance of Biomarkers in Predicting Septic Cardiomyopathy: A Study on Procalcitonin, NT-proBNP, and Troponin T in Sepsis Patients

Session: SESSÃO DE POSTERS 33 - DOENÇAS CARDIOVASCULARES - MINOCA E SÍNDROME DE TAKOTSUBO
Speaker: Rita Figueiredo

Congress: CPC 2025
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 14. Acute Cardiac Care
Subtheme: 14.3 Acute Cardiac Care – CCU, Intensive, and Critical Cardiovascular Care
Session Type: Cartazes
FP Number: ---
Authors: Ana Rita M. Figueiredo; Catarina Gregório; Miguel Raposo; Ana Abrantes; João Fonseca; Marta Vilela; Daniel Cazeiro; Diogo Ferreira; João Cravo; Sofia Esteves; Susana M. Fernandes; Doroteia Silva

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Sepsis-induced myocardial dysfunction is a major cause of morbidity and mortality in critically ill patients and early identification of patients at risk can significantly impact prognosis. Various biomarkers have been investigated as potential predictors of this condition but none is well defined.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Purpose:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> To assess the ability of procalcitonin, NT-proBNP, troponin, and their peak values to predict the occurrence of septic cardiomyopathy in septic patients.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Retrospective, observational study of consecutive patients with sepsis diagnosis, admitted in a Polivalent Intensive Care Unit. The area under the curve (AUC), sensitivity, specificity, and diagnostic accuracy were calculated to assess the predictive value of the 3 biomarkers.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">A total of 306 patients were included, of which 19% had septic cardiomyopathy (SC) and 81% did not. The prevalence of cardiovascular comorbidities and prior structural heart disease was comparable between the two groups (SC: 20.4% vs. no SC: 22.2%).</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"> </span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Procalcitonin, NT-proBNP and troponin T levels were investigated as potential predictors of SC.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">At admission, procalcitonin exhibited an area under the curve (AUC) of 0.608, with an optimal cutoff value of 38.55, yielding a sensitivity of 48.3%, specificity of 74.2%, and diagnostic accuracy of 1.225. These results suggest that procalcitonin has limited diagnostic utility for septic cardiomyopathy, with relatively low sensitivity. NT-proBNP at admission demonstrated a slightly higher AUC of 0.653, with a cutoff of 11072, resulting in a sensitivity of 58.5%, specificity of 75.2%, and diagnostic accuracy of 1.337. While NT-proBNP showed better performance than procalcitonin, its diagnostic accuracy remains moderate.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Troponin T at peak levels showed the highest AUC (0.684), with a cutoff value of 238, sensitivity of 46.6%, specificity of 85.3%, and diagnostic accuracy of 1.319. Despite its lower sensitivity, peak troponin T exhibited excellent specificity, indicating its potential role in ruling out septic cardiomyopathy. Peak procalcitonin demonstrated an AUC of 0.630, with a sensitivity of 63.8% and specificity of 63.3%, yielding a diagnostic accuracy of 1.271. This suggests a moderate performance but does not outperform the other markers. Finally, peak NT-proBNP showed an AUC of 0.663, with a cutoff value of 11180.5, sensitivity of 60%, specificity of 72.8%, and diagnostic accuracy of 1.328, making it the most promising marker in this study for predicting septic cardiomyopathy.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">While none of the biomarkers demonstrated high diagnostic accuracy, peak NT-proBNP and peak troponin T showed the best diagnostic performance. These findings suggest that a strategy of biomarkers combination, especially of their peak values, may enhance the diagnosis of septic cardiomyopathy in septic patients</span></span></span></p>