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.
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.
Authors: Lars W Andersen; Julie Mackenhauer; Jonathan C Roberts; Katherine M Berg; Michael N Cocchi; Michael W Donnino Journal: Mayo Clin Proc Date: 2013-10 Impact factor: 7.616
Authors: Oliver Matz; Jan Heckelmann; Sebastian Zechbauer; Jens Litmathe; Jörg C Brokmann; Klaus Willmes; Jörg B Schulz; Manuel Dafotakis Journal: Intern Emerg Med Date: 2017-09-12 Impact factor: 3.397
Authors: Taek Kyu Park; Jeong Hoon Yang; Seung-Hyuk Choi; Young Bin Song; Joo-Yong Hahn; Jin-Ho Choi; Kiick Sung; Young Tak Lee; Hyeon-Cheol Gwon; Sang Hoon Lee Journal: Yonsei Med J Date: 2014-07 Impact factor: 2.759