The role of procalcitonin in acute heart failure patients.

Acute dyspnoea is a common chief complaint in the emergency department and is mainly caused by cardiac and pulmonary underlying diagnoses. In patients with acute heart failure (AHF), an early initiation of adequate therapy is important to improve patient outcome. Clinical differentiation of pulmonary and cardiac underlying causes and of concomitant pathologies determines which therapeutic strategy is chosen. Procalcitonin is a marker of bacterial infection, which is markedly increased in AHF patients with concomitant bacterial infection and thus has the potential to guide the early initiation of adequate antibiotic therapy. The IMPACT-EU trial is a multicenter randomized controlled trial designed to test this hypothesis. This mini-review summarizes the current literature on procalcitonin in AHF and explains the design of the IMPACT-EU trial.