Correlation analysis of arterial blood lactate levels with major in-hospital adverse cardiovascular events after coronary intervention in patients with acute myocardial infarction

OBJECTIVE: To evaluate the relationship between percutaneous coronary intervention (PCI) and major in-hospital adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (PCI) after PCI by monitoring the level of arterial lactate at the time of admission. METHODS: A total of 77 patients with acute myocardial infarction who received emergency PCI treatment in our hospital from June 2022 to December 2023 were enrolled, and they were divided according to the preoperative arterial blood lactate level after admission, the control group (40 cases) with normal lactate and the observation group (37 cases) with elevated lactate were enrolled. At the same time, the following major cardiovascular adverse events in the hospital were recorded during the course of the disease: cardiogenic death, cardiogenic shock, new-onset heart failure, angina/exacerbation of pre-existing heart failure, and malignant arrhythmia. RESULTS: The incidence of major cardiovascular adverse events in the observation group was higher than that in the control group, and the difference was statistically significant(P < 0.05). Compared with the control group, the observation group had a higher peak cTnI (P < 0.05), a faster heart rate (P < 0.05), a lower systolic blood pressure (P < 0.05), a higher fasting blood glucose (P < 0.05), and a longer time from symptom to catheter (P < 0.05). With the increase of lactate level, the incidence of major cardiovascular adverse events in the hospital showed an overall upward trend. Binary logistic regression analysis showed that heart rate, systolic blood pressure, elevated lactate and fasting blood glucose were the main factors associated with in-hospital adverse cardiovascular events in patients with acute myocardial infarction after PCI. CONCLUSIONS: The level of lactate in the arterial blood can be used as an effective early warning indicator to evaluate the occurrence of major adverse cardiovascular events in the hospital.