The effect of lactate levels on prognosis in patients with ST-segment elevation myocardial infarction

Abstract

Aim: The prognostic role of lactate for early mortality in patients with ST-segment elevation myocardial infarction (STEMI) submittedto primary percutaneous transluminal coronary angiography (PTCA) is not elucidated clearly. This study was conducted with patientsthat presented to the emergency department (ED) with STEMI and underwent PTCA to investigate whether the changes in lactatevalues from ED admission to 24 hours after PTCA affected mortality.Material and Methods: This prospective observational study on 143 patients with STEMI was conducted at emergency service andtertiary-level cardiology clinic in a public university hospital. The documentation for each patient included detailed information ondemographics, type of myocardial infarction according to electrocardiography and PTCA results, duration of hospital stay, vital signs,laboratory fidings on admission, lactate levels 24 hours after PTCA, and outcome (hospital discharge or death).Results: The lactate values are higher in non-surviving groups measured 24 hours after PTCA (P < 0.001). The differences in thelactate levels from the time of admission to 24 hours after PTCA were signifiantly lower in the non-surviving group (P < 0.001).Conclusion: Among patients presenting to the ED with STEMI, a high lactate level is associated with mortality. Also, the differencebetween lactate values of the patients after PTCA is associated with the risk of mortality. Therefore, we consider that fist lactatelevels in ED and last lactate levels after PTCA in patients with STEMI can provide physicians with an insight into the possibility ofmortality