Lactate clearance in cardiogenic shock following ST elevation myocardial infarction: A pilot study

Paola Attaná, Chiara Lazzeri, Marco Chiostri, Claudio Picariello, Gian Franco Gensini, Serafina Valente

Research output: Contribution to journalArticle

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 KaplanMeier 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.

Original languageEnglish
Pages (from-to)20-26
Number of pages7
JournalAcute Cardiac Care
Volume14
Issue number1
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Cardiovascular diseases
  • Myocardial infarction
  • Shock

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Emergency Medicine

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    Attaná, P., Lazzeri, C., Chiostri, M., Picariello, C., Gensini, G. F., & Valente, S. (2012). Lactate clearance in cardiogenic shock following ST elevation myocardial infarction: A pilot study. Acute Cardiac Care, 14(1), 20-26. https://doi.org/10.3109/17482941.2011.655293