Key result
A C-reactive protein level of ≥105 mg/dL strongly predicted the diagnosis of definitive infective endocarditis, increasing the odds by 10 times (OR 10.0).
Why the study?
In patients with prosthetic valves or intracardiac devices, infective endocarditis is difficult to diagnose and frequently missed.
Does C-reactive protein level predict definitive infective endocarditis in patients with suspected prosthetic valve or intracardiac device endocarditis?
Observational (n=94)
No
Does C-reactive protein level predict definitive infective endocarditis in patients with suspected prosthetic valve or intracardiac device endocarditis?
A C-reactive protein level of ≥105 mg/dL is a strong, simple, and reliable independent predictor for diagnosing definitive infective endocarditis in patients with prosthetic valves or intracardiac devices.
Answers are grounded in this paper and cite their sources.
CRP ≥105 mg/dL may aid definitive IE diagnosis in prosthetic/device patients; leaves open prospective validation before changing practice.
BACKGROUND: The use of prosthetic valves and intracardiac devices has steadily increased in recent years. In this group of patients with prosthetic valves or intracardiac devices, infective endocarditis could not be easily diagnosed, and in general, infective endocar- ditis can be missed in many patients. The purpose of this study was to evaluate the diag- nostic performance of clinical, laboratory, and imaging parameters in a group of patients with pre-diagnosis of infective endocarditis. METHODS: Ninety-four patients diagnosed with prosthetic valve or intracardiac device endocarditis during 2008-2019 were included in the study. The patients' data were evalu-ated according to modified Duke criteria, and the data of the patients who were diag- nosed with and without a definitive infective endocarditis were compared accordingly. RESULTS: Values of procalcitonin (P < .001), leukocytes (P=.004), C-reactive protein (P < .001), sedimentation (P < .001), and maximal vegetation size (P = .012) were found to be significant in the diagnosis of IE. Criteria to determine definitive IE included a C-reactive protein level of 105 mg/dL or higher, 77% sensitivity, 75% specificity, 60% positive predic- tive value, and 87% negative predictive value. In particular, a C-reactive protein level of ≥105 mg/dL was found to positively indicate the diagnosis of definitive infective endocar- ditis by 10 times (odds ratio = 10; 95% CI: 3.6-27.8, P < .001). In a multiple logistic regression analysis, the C-reactive protein level was found to be the best independent predictor of definitive infective endocarditis in this population. CONCLUSION: In cases of prosthetic valve and intracardiac devices endocarditis where pre- diagnosis is difficult to confirm, measuring C-reactive protein levels is a reliable, strong, and simple parameter for definitive infective endocarditis diagnosis.
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Hamzayev et al. (2022) conducted an observational in Prosthetic valve or intracardiac device endocarditis (n=94). C-reactive protein (CRP) level ≥105 mg/dL vs. CRP level <105 mg/dL was evaluated on Definitive infective endocarditis diagnosis (OR 10.0, 95% CI 3.6-27.8, p=<0.001). A C-reactive protein level of ≥105 mg/dL strongly predicted the diagnosis of definitive infective endocarditis, increasing the odds by 10 times (OR 10.0).
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