Lactate clearance in cardiogenic shock following ST elevation myocardial infarction: A pilot study
- 24 January 2012
- journal article
- Published by Taylor & Francis Ltd in Acute Cardiac Care
- Vol. 14 (1), 20-26
- https://doi.org/10.3109/17482941.2011.655293
Abstract
Background: Recent studies documented that serial lactate measurements over time may be clinically more reliable than lactate absolute value for risk stratification. The aim of the present investigation was to assess the role of lactate clearance in predicting early death in cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI). Methods: 51 consecutive patients with CS following STEMI were prospectively enrolled. Lactate was measured in Intensive Cardiac Care Unit (ICCU) on admission and on the twelfth hour. Logistic regression analysis was performed to identify the independent predictors for in-ICCU mortality. Receiver operating characteristic (ROC) curve was constructed in order to identify cut-off for admission lactate and for 12-h lactate clearance in relation to in-ICCU mortality. Follow-up survival rate were investigated by Kaplan–Meier curves. Results: At 12 h from admission, lactate clearance was higher in survivors (P = 0.013). A higher in-ICCU mortality was observed in patients with 12 hours lactate clearance < 10% (P = 0.002). At follow up, patients with 12-h lactate clearance < 10% showed a significantly lower survival rate. Conclusions: In patients with CS following STEMI, 12-h lactate clearance < 10% identifies a subset of patients at higher risk for death at short and long-term.Keywords
This publication has 28 references indexed in Scilit:
- Lactate in the acute phase of ST-elevation myocardial infarction treated with mechanical revascularization: A single-center experienceThe American Journal of Emergency Medicine, 2012
- Experience with revascularization procedures does matter: low volume means worse outcomeEuropean Heart Journal, 2010
- Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis TherapyA Randomized Clinical TrialJama-Journal Of The American Medical Association, 2010
- Cardiogenic ShockHospital Practice, 2010
- Clinical correlates of arterial lactate levels in patients with ST-segment elevation myocardial infarction at admission: a descriptive studyCritical Care, 2010
- MULTICENTER STUDY OF EARLY LACTATE CLEARANCE AS A DETERMINANT OF SURVIVAL IN PATIENTS WITH PRESUMED SEPSISShock, 2009
- NT-proBNP on admission for early risk stratification in STEMI patients submitted to PCI. Relation with extension of STEMI and inflammatory markersInternational Journal of Cardiology, 2009
- Occurrence and adverse effect on outcome of hyperlactatemia in the critically illCritical Care, 2009
- Time of onset and outcome of cardiogenic shock in acute coronary syndromesJournal of Cardiovascular Medicine, 2008
- APACHE IICritical Care Medicine, 1985