What is the clinical evidence from this study?

Study design: Observational. Population: Acute myocardial infarction complicated with cardiac shock (AMICS) (n=395). Intervention: Early arterial lactate, arterial bicarbonate ion, and lactate/albumin ratio. Primary outcome: In-hospital mortality.

What question did this study set out to answer?

This research aims to assess the link between early arterial lactate, bicarbonate levels, and lactate/albumin ratio with in-hospital mortality in AMICS patients.

April 8, 2026Open Access

Correlation Between Early Arterial Lactate Levels, Arterial Bicarbonate Ion Levels, and the Lactate/Albumin Ratio and In‐Hospital Mortality in Patients With Acute Myocardial Infarction Complicated With Cardiac Shock

Key Result

Early arterial bicarbonate ion (AUC 0.707), arterial lactate (AUC 0.679), and the lactate/albumin ratio (AUC 0.670) were predictive of in-hospital mortality in patients with AMICS.

Key Points

This research aims to assess the link between early arterial lactate, bicarbonate levels, and lactate/albumin ratio with in-hospital mortality in AMICS patients.
Analyzed 395 patients with acute myocardial infarction and cardiac shock.
Utilized ROC curve for predictive value assessment of arterial lactate, bicarbonate level, and lactate/albumin ratio.
Employed Kaplan-Meier survival curves to determine median survival times across subgroups.
Applied Cox proportional risk model to explore the relationship between indicators and all-cause mortality.
The ROC analysis indicated predictive areas under the curve of 0.707 for bicarbonate, 0.679 for lactate, and 0.670 for lactate/albumin ratio.
Median survival was shorter in the low bicarbonate group compared to the high bicarbonate group.
Higher lactate levels and lactate/albumin ratios correlated with increased mortality risk, while higher bicarbonate levels were protective.

Study Design

Type

Observational (n=395)

Structured PICO

Population

395 patients with acute myocardial infarction complicated with cardiac shock (AMICS)

Outcome

In-hospital mortality (all-cause mortality during hospitalization)hard clinical

Early arterial bicarbonate ion levels, arterial lactate levels, and the lactate/albumin ratio are predictive of in-hospital all-cause mortality in patients with acute myocardial infarction complicated by cardiogenic shock.

Abstract

Background To investigate the connection between early arterial lactate, arterial bicarbonate ion, lactate/albumin ratio (L/A) and in‐hospital mortality in patients with acute myocardial infarction complicated with cardiac shock (AMICS). Methods A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of these indicators for in‐hospital mortality in 395 patients with AMICS. A Kaplan‒Meier survival curve was drawn to analyze the median survival time of each subgroup. A Cox fitted proportional risk model was used to verify the association between these indicators and all‐cause mortality during hospitalization. Results ROC curve analysis revealed that the areas under the curve for arterial bicarbonate ion level, arterial lactate level, and L/A were 0.707, 0.679, and 0.670, respectively, indicating that these parameters have certain value for predicting in‐hospital mortality in patients with AMICS. The Kaplan‒Meier survival curve revealed that the median survival time of the low bicarbonate ion group was shorter than that of the high bicarbonate ion group, and the median survival time of the low lactic acid group and low L/A group was longer than that of the high lactic acid group and the high L/A group. The Cox proportional risk model indicated that higher arterial bicarbonate ion levels were a protective factor for in‐hospital death in AMICS patients and that higher arterial lactate levels and a higher L/A were independent risk factors. Conclusion Early arterial bicarbonate ion levels, arterial lactate levels, and the L/A were predictive of all‐cause death in AMICS patients.