The Role of s-TREM in Distinction of Congestive Heart Failure and Pneumonia in Patients With Dyspnea in the Emergency Department

Abstract

Aim: Congestive heart failure (CHF) and pneumonia are the most important causes of potentially death due to dyspnea in patients presenting at the Emergency Department. Early diagnosis and suitable treatment are lifesaving in cases of both CHF and pneumonia. The aim of this study was to investigate the diagnostic ability of the soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) which is an inflammatory biomarker in the differential diagnosis of pneumonia from CHF. Material and Method:This prospective study was conducted from 1 Jun 2014 to 30 May 2015 in the emergency medicine departments of urban and university hospitals. Patients presenting with dyspnea were evaluated and divided into two groups according to the diagnoses made according to international guidlines; CHF group and pneumonia group. The groups were compared in respect of clinical and demographic characteristics and sTREM-1 levels.Results: 15 patients were evaluated in each group. Pulse rate was higher in the CHF group (p<0.001), and respiration rate and temperature values were higher in the pneumonia group (p=0.002, p=0.008). On the chest radiographs, significant infiltration was observed in the pneumonia group, and cardiomegaly in the CHF group (p<0.001). The sTREM-1 levels were higher in the pneumonia group than the CHF group, and the difference was statistically significant (p=0.044). Conclusion:We think that STEM can be used in the differential diagnosis of dyspnea in the emergency departments, but this should be supported by more comprehensive studies.