Prognostic Value of Admission Lactate Level in Patients With Myocardial Infarction With ST Segment Elevation

INTRODUCTION: Lactate is a product of anaerobic metabolism and increases in states of tissue hypoxia. Furthermore, it is demonstrated that lactate level is correlated with the extent of infarct area and short term (30-day) mortality rates in patients with acute coronary syndrome with ST segment elevation (STE-ACS). Therefore, we aimed to test the prognostic value of this easily obtainable parameter on outcomes in patients presenting with STE-ACS.
METHODS: All adult patients who admitted with STE-ACS between 2019 and 2020 were screened. The cases with admission lactate levels were included. Patients were separated into two groups as low (<2mmol/l) and high (>2mmol/l) lactate groups.
RESULTS: A total of 70 patients were enrolled. The mean age of the study population was 62.3 ± 15.0 years and 53 (75.7%) of them were male. The most common infarct related artery was the left anterior descending (LAD) artery. The median lactate level was 2.5 (0.80-15.3) mmol/L. Malignant arrhythmia, contrast induced nephropathy (CIN), and in-hospital mortality rates were not different between the high and low lactate groups. However, all-cause mortality was significantly higher in the high lactate group during the follow-up (p=0.005). Among all included parameters; lactate level [OR: 1.76, (CI: 1.28-2.42);p<0.001] and age [OR: 1.10, (CI: 1.03-1.17); p=0.004] were predictors for all-cause mortality.
DISCUSSION AND CONCLUSION: Admission lactate level can predict all-cause mortality in patients with STE-ACS. In addition, high-admission lactate could help to raise more attention even if the patients have been discharged from the hospital.