Abstract
Objectives: Metabolic acidosis has been described after myocardial infarction, but little data are available on the acid-base imbalance in ST-elevation myocardial infarction (STEMI) submitted to mechanical revascularization, and earlier studies on this topic differ with respect to patients' selection criteria, treatment and evaluated parameters. Methods: We assessed admission base excess, anion gap, and lactate in 445 consecutive patients with STEMI submitted to primary percutaneous coronary intervention and whether its evaluation could help in identifying patients at a higher risk for in-hospital mortality and complications (acute pulmonary edema and arrhythmias). Results: At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU mortality: age [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.02-1.10; P=0.006], estimated glumerular filtration rate (OR 0.98; 95% CI 0.96-0.99; P=0.010), Tn I (OR 1.006; 95% CI 1.004-1.008; P2: 5.69, P=0.681. At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU complications: left ventricular ejection fraction (OR 0.95; 95% CI 0.91-0.98; P=0.005) and lactic acid (OR 1.31; 95% CI 1.10-1.57; P=0.003); Hosmer-Lemeshow χ2: 4.11, P=0.847. Conclusion: According to our findings, the evaluation of base excess and lactate in the early phase of STEMI provides the bedside clinicians with useful tools for early risk stratification. In fact, base excess proved to be an independent predictor for intra-ICCU mortality, whereas lactate represented an independent marker for intra-ICCU complications.
| Original language | English |
|---|---|
| Pages (from-to) | 266-272 |
| Number of pages | 7 |
| Journal | Coronary Artery Disease |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2010 |
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Keywords
- acid-base imbalance
- percutaneous coronary intervention
- prognosis
- STEMI
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Evaluation of acid-base balance in ST-elevation myocardial infarction in the early phase : A prognostic tool? / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Picariello, Claudio; Gensini, Gian Franco.
In: Coronary Artery Disease, Vol. 21, No. 5, 2010, p. 266-272.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of acid-base balance in ST-elevation myocardial infarction in the early phase
T2 - A prognostic tool?
AU - Lazzeri, Chiara
AU - Valente, Serafina
AU - Chiostri, Marco
AU - Picariello, Claudio
AU - Gensini, Gian Franco
PY - 2010
Y1 - 2010
N2 - Objectives: Metabolic acidosis has been described after myocardial infarction, but little data are available on the acid-base imbalance in ST-elevation myocardial infarction (STEMI) submitted to mechanical revascularization, and earlier studies on this topic differ with respect to patients' selection criteria, treatment and evaluated parameters. Methods: We assessed admission base excess, anion gap, and lactate in 445 consecutive patients with STEMI submitted to primary percutaneous coronary intervention and whether its evaluation could help in identifying patients at a higher risk for in-hospital mortality and complications (acute pulmonary edema and arrhythmias). Results: At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU mortality: age [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.02-1.10; P=0.006], estimated glumerular filtration rate (OR 0.98; 95% CI 0.96-0.99; P=0.010), Tn I (OR 1.006; 95% CI 1.004-1.008; P2: 5.69, P=0.681. At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU complications: left ventricular ejection fraction (OR 0.95; 95% CI 0.91-0.98; P=0.005) and lactic acid (OR 1.31; 95% CI 1.10-1.57; P=0.003); Hosmer-Lemeshow χ2: 4.11, P=0.847. Conclusion: According to our findings, the evaluation of base excess and lactate in the early phase of STEMI provides the bedside clinicians with useful tools for early risk stratification. In fact, base excess proved to be an independent predictor for intra-ICCU mortality, whereas lactate represented an independent marker for intra-ICCU complications.
AB - Objectives: Metabolic acidosis has been described after myocardial infarction, but little data are available on the acid-base imbalance in ST-elevation myocardial infarction (STEMI) submitted to mechanical revascularization, and earlier studies on this topic differ with respect to patients' selection criteria, treatment and evaluated parameters. Methods: We assessed admission base excess, anion gap, and lactate in 445 consecutive patients with STEMI submitted to primary percutaneous coronary intervention and whether its evaluation could help in identifying patients at a higher risk for in-hospital mortality and complications (acute pulmonary edema and arrhythmias). Results: At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU mortality: age [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.02-1.10; P=0.006], estimated glumerular filtration rate (OR 0.98; 95% CI 0.96-0.99; P=0.010), Tn I (OR 1.006; 95% CI 1.004-1.008; P2: 5.69, P=0.681. At backward stepwise logistic regression analysis, the following variables were independently associated with intra-ICCU complications: left ventricular ejection fraction (OR 0.95; 95% CI 0.91-0.98; P=0.005) and lactic acid (OR 1.31; 95% CI 1.10-1.57; P=0.003); Hosmer-Lemeshow χ2: 4.11, P=0.847. Conclusion: According to our findings, the evaluation of base excess and lactate in the early phase of STEMI provides the bedside clinicians with useful tools for early risk stratification. In fact, base excess proved to be an independent predictor for intra-ICCU mortality, whereas lactate represented an independent marker for intra-ICCU complications.
KW - acid-base imbalance
KW - percutaneous coronary intervention
KW - prognosis
KW - STEMI
UR - http://www.scopus.com/inward/record.url?scp=77954643705&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954643705&partnerID=8YFLogxK
U2 - 10.1097/MCA.0b013e32833b20c6
DO - 10.1097/MCA.0b013e32833b20c6
M3 - Article
C2 - 20617567
AN - SCOPUS:77954643705
VL - 21
SP - 266
EP - 272
JO - Coronary Artery Disease
JF - Coronary Artery Disease
SN - 0954-6928
IS - 5
ER -