Hyperlactatemia and the Outcome of Type 2 Diabetic Patients Suffering Acute Myocardial Infarction

Area of Science:

• Cardiology
• Endocrinology
• Biochemistry

Background:

• Unregulated diabetes mellitus is often associated with increased lactate production.
• Lactate elevation is a known complication in various disease states, including cardiovascular events.

Purpose of the Study:

• To investigate and compare blood lactate levels in patients with type 2 diabetes mellitus and acute myocardial infarction (DM+AMI) versus non-diabetic patients with myocardial infarction (MI).
• To assess the correlation of lactate levels with clinical outcomes in diabetic patients experiencing acute myocardial infarction.

Main Methods:

• A comparative study involving three groups: DM+AMI (n=40), MI (n=40), and diabetes mellitus (DM) without cardiovascular pathology (n=40).
• Measurements included pH, serum bicarbonate, electrolytes, blood lactate, and creatine kinase-MB (CK-MB).

Main Results:

• Blood lactate levels were significantly higher in the DM+AMI group (4.54 ± 1.44 mmol/L) compared to the MI group (3.19 ± 1.005 mmol/L) (p < 0.05).
• Elevated lactate in DM+AMI correlated with heart failure (ρ = 0.66), cardiac rhythm disorders (ρ = 0.54), low oxygen saturation (ρ = 0.72), elevated CK-MB (ρ = 0.62), and poor short-term outcomes.
• Lactic acidosis in DM+AMI was not invariably linked to a fatal outcome.

Conclusions:

• Defective glucose metabolism and reduced tissue oxygenation likely contribute to increased lactate production in diabetic patients with AMI.
• High blood lactate levels in diabetic patients with AMI signify an elevated risk for adverse outcomes, including heart failure, arrhythmias, cardiogenic shock, and increased mortality, compared to non-diabetic MI patients.