Abstract Background Arterial lactate on admission has been shown to be associated with shock severity and outcomes in patients with infarct-related cardiogenic shock (CS). Recently in has been speculated that there might a difference in the prognostic value of lactate between patients after pre-hospital cardiac arrest (CA) versus no CA. Methods Patients included in three randomized clinical trials (IABP-SHOCK II; CULPRIT-SHOCK; ECLS-SHOCK) investigating treatments in CS were centrally analysed. For this sub-analysis patients were divided into two groups: pre-hospital CA versus no CA. Arterial lactate levels on admission were divided into tertiles ( 3.6, 3.6-7.1 and 7.1 mmol/l). The primary endpoint was 1-year total mortality. Results A total of 1404 patients (805 with CA and 599 without CA) were included into this analysis. There were more patients with the highest lactate tertile in the CA group. The level of lactate was associated with 365-day mortality regardless of CA or no CA (Table 1). Conclusions Arterial lactate levels on admission are associated with 1-year mortality in patients with infarct-related CS regardless of pre-hospital CA or no CA. Patients without CA had lower lactate levels, however, if they had lactate levels in the highest tertile, mortality was very high.
Zeymer et al. (Sat,) studied this question.