ArticlePloS one2017
Biomarker-based diagnosis of pacemaker and implantable cardioverter defibrillator pocket infections: A prospective, multicentre, case-control evaluation.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01619267 (Device Associated Infections - Role of New Diagnostic Tools), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Device Associated Infections - Role of New Diagnostic Tools
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cardiovascular Implantable Electronic Device Infection and New Insights About Correlation Between Pro-inflammatory Markers and Heart Failure: A Systematic Literature Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- Beyond the Pocket: Clinical, Routine Biomarker, and Microbiological Associations with Systemic Versus Localized Cardiovascular Implantable Electronic Device Infection.Diagnostics (Basel, Switzerland) · 2026Article
- Routine Inflammation-Haemostasis Panel in Transvenous Lead Extraction: An Exploratory Prospective Single-Centre Cohort Study.Journal of clinical medicine · 2026Article
- Vacuum-Assisted Percutaneous Management of Cardiac Implantable Electronic Device Lead Endocarditis.Journal of clinical medicine · 2026Review
- Assessment of antibiotic prophylaxis post cardiac implantable electronic device implantation: a retrospective cohort study.BMC infectious diseases · 2026Article
- Injectable ε-poly-lysine/hyaluronic acid hydrogel for targeted prevention of cardiovascular implantable electronic device pocket infections.RSC advances · 2026Article
- Inflammatory biomarkers as predictors of systemic vs isolated pocket infection in patients undergoing transvenous lead extraction.Heart rhythm O2 · 2024Article
- Physiologic postoperative presepsin kinetics following primary cementless total hip arthroplasty: A prospective observational study.World journal of orthopedics · 2023Article
- Cardiac Implantable Electronic Devices Infection Assessment, Diagnosis and Management: A Review of the Literature.Journal of clinical medicine · 2022Review
- European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections-endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020Article
- Approach to Diagnosis of Cardiovascular Implantable-Electronic-Device Infection.Journal of clinical microbiology · 2018Review
- The Diagnosis and Treatment of Pacemaker-Associated Infection.Deutsches Arzteblatt international · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of cardiac implantable electronic devices (CIED) has risen steadily, yet the rate of cardiac device infections (CDI) has disproportionately increased. Amongst all cardiac device infections, the pocket infection is the most challenging diagnosis. Therefore, we aimed to improve diagnosis of such pocket infection by identifying relevant biomarkers.
methodsWe enrolled 25 consecutive patients with invasively and microbiologically confirmed pocket infection. None of the patients had any confounding conditions. Pre-operative levels of 14 biomarkers were compared in infected and control (n = 50) patients. Our selected biomarkers included white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide binding protein, high-sensitivity C-reactive protein (HS-CRP), polymorphonuclear-elastase, presepsin, various interleukins, tumor necrosis factor α (TNF-α), and granulocyte macrophage colony-stimulating factor (GM-CSF).
resultsOf the 25 patients with isolated pocket infection (70±13years, 76% male, 40% ICDs), none presented with leukocytosis. In contrast, they had higher serum levels of HS-CRP (p = 0.019) and PCT (p = 0.010) than control patients. Median PCT-level was 0.06 ng/mL (IQR 0.03-0.07 ng/mL) in the study group versus 0.03 ng/mL (IQR 0.02-0.04 ng/mL) in controls. An optimized PCT cut-off value of 0.05 ng/mL suggests pocket infection with a sensitivity of 60% and specificity of 82%. In addition TNF-α- and GM-CSF-levels were lower in the study group. Other biomarkers did not differ between groups.
conclusionDiagnosis of isolated pocket infections requires clinical awareness, physical examination, evaluation of blood cultures and echocardiography assessment. Nevertheless, measurement of PCT- and HS-CRP-levels can aid diagnosis. However, no conclusion can be drawn from normal WBC-values. CLINICAL
trial registrationclinicaltrials.gov identifier: NCT01619267.
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