Blood lactate is a predictor of short-term mortality in patients with myocardial infarction complicated by heart failure but without cardiogenic shock
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Key result
In patients with acute myocardial infarction and mild to moderate heart failure (Killip class II-III), elevated blood lactate (≥2.5 mmol/L) was associated with a significantly higher 30-day mortality (28% vs 5%, HR 5.94).
Why the study?
Does blood lactate ≥2.5 mmol/L predict 30-day mortality in patients with AMI complicated by mild to moderate heart failure without cardiogenic shock?
Population
77 patients with acute myocardial infarction and signs of heart failure who underwent PCI in 2014…
Comparison
Blood lactate ≥2.5 mmol/L vs Blood lactate <2.5 mmol/L
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
Lactate may aid short-term risk stratification in MI with HF; leaves open whether targeted interventions improve outcomes.
Study Design
Type
Cohort (n=1,158)
Multicenter
No
Structured PICO
Does blood lactate ≥2.5 mmol/L predict 30-day mortality in patients with AMI complicated by mild to moderate heart failure without cardiogenic shock?
P
Population
1,158 patients with acute myocardial infarction undergoing percutaneous coronary intervention, including 65 with mild to moderate heart failure (Killip class II-III), followed for up to 1 year.
E
Exposure
Blood lactate ≥2.5 mmol/L
C
Comparator
Blood lactate <2.5 mmol/L
O
Outcome
30-day mortalityhard clinical
Main Result
Hazard Ratio: 5.94 (95% CI 1.23–28.64)
Absolute Event Rate: 28% vs 5%
p-value: p=0.026
In patients with AMI and mild to moderate heart failure, a blood lactate level ≥2.5 mmol/L is a strong predictor of 30-day mortality.
Limitations
- Relatively small number of available subjects from a single center
- Retrospective review of manually recorded registry data
- Exact time of lactate measurement relating to the angiographic procedure cannot accurately be decided retrospectively
- Time from symptom debut not available
- Peak lactate and lactate development were not collected
Cite This Study
Gjesdal et al. (2018) conducted a cohort in Acute myocardial infarction complicated by heart failure (n=1,158). Elevated blood lactate (≥2.5 mmol/L) vs. Blood lactate < 2.5 mmol/L was evaluated on 30-day mortality in patients with Killip class II-III (HR 5.94, 95% CI 1.23-28.64, p=0.026). In patients with acute myocardial infarction and mild to moderate heart failure (Killip class II-III), elevated blood lactate (≥2.5 mmol/L) was associated with a significantly higher 30-day mortality (28% vs 5%, HR 5.94).
Topics
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