Lactate Values and Mortality in Patients With Cardiogenic Shock: Insights From the Altshock-2 Registry

Matteo Pagnesi; Mauro Riccardi; Alice Sacco; Giovanna Viola; Fabrizio Oliva; Simone Frea; Martina Briani; Letizia Bertoldi; Maurizio Bertaina; Luciano Potena; Serafina Valente; Marco Marini; Gaetano Maria De Ferrari; Nicoletta D’Ettore; Astrid Cardinale; Rita Camporotondo; Matteo Rota; Guido Tavazzi; Nuccia Morici; Federico Pappalardo; Marco Metra

doi:10.1097/ccm.0000000000006738

Key Points

To evaluate the prognostic value of baseline and 24-hour plasma lactate concentrations for predicting in-hospital mortality in patients presenting with cardiogenic shock.
Conducted across 12 centers in Italy under trial registration NCT04295252, evaluating 651 consecutive patients with cardiogenic shock and available lactate data.
Measured plasma lactate concentrations upon hospital admission and at 24 hours, assessing variations among patients managed with mechanical circulatory support.
Evaluated the association with in-hospital mortality using multivariable logistic regression and determined optimal predictive cutoffs using receiver operating characteristic analysis.
Baseline and 24-hour lactates independently predicted in-hospital mortality per 1-mmol/L increase (adjusted OR 1.08 [95% CI, 1.02–1.14] and adjusted OR 1.37 [95% CI, 1.15–1.63], respectively).
Lactate at 24 hours demonstrated superior prognostic accuracy compared to baseline lactate (area under the curve 0.702 vs. 0.648).
Optimal cutoff thresholds for predicting mortality were 3.2 mmol/L at admission and 1.7 mmol/L at 24 hours, varying according to the mechanical circulatory support strategy applied.

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Implication

Finds 24-hour lactate levels strongly predict in-hospital mortality in cardiogenic shock, indicating delayed clearance is a crucial prognostic marker.

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Cite This Study

Pagnesi et al. (2025) studied this question.

synapsesocial.com/papers/6a8d59db0db1783955dcd6b8 https://doi.org/10.1097/ccm.0000000000006738

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Lactate Values and Mortality in Patients With Cardiogenic Shock: Insights From the Altshock-2 Registry

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Lactate Values and Mortality in Patients With Cardiogenic Shock: Insights From the Altshock-2 Registry

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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