Related Experiment Video
Updated: Jul 7, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Prognostic value of arterial lactate index in ST-elevation myocardial infarction treated with primary percutaneous
Ahmed Abdel-Salam1, Amr El-Sayed1, Ahmed Abdel-Haseeb1
1Cardiology department, Ain Shams University, Cairo, 7154411, Egypt.
Insights
Elevated serum lactate in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) indicates worse outcomes. Higher lactate levels correlate with adverse periprocedural variables and increased 30-day major adverse cardiovascular events (MACE).
Area of Science:
- Cardiology
- Biochemistry
- Critical Care Medicine
Background:
- The pathophysiological mechanisms linking serum lactate to myocardial injury beyond simple association are not fully understood.
- Serum lactate is a known marker in critical illness, but its specific prognostic role in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) requires further elucidation.
Purpose of the Study:
- To evaluate the prognostic significance of the lactate index in relation to periprocedural variables.
- To assess the impact of lactate levels on 30-day major adverse cardiovascular events (MACE) in STEMI patients undergoing pPCI.
Main Methods:
- A prospective study involving 300 STEMI patients undergoing pPCI.
- Assessment of admission lactate levels and their correlation with clinical parameters (Killip class), procedural outcomes (TIMI flow, myocardial blush grade), and cardiac biomarkers (CK-MB, troponin).
- Evaluation of the association between lactate levels and 30-day MACE.
Main Results:
- Admission lactate levels showed significant correlations with Killip class, periprocedural time intervals, post-pPCI TIMI flow, and myocardial blush grade (MBG).
- Higher lactate levels were associated with reduced ST-deviation resolution, elevated cardiac enzymes (CK-MB, troponin), and lower ejection fraction.
- Lactate levels were a significant predictor of 30-day MACE (p < 0.001).
Conclusions:
- Hyperlactatemia in STEMI patients undergoing pPCI is linked to poorer clinical status, suboptimal reperfusion, larger infarct size, and increased risk of 30-day MACE.
- Serum lactate serves as a valuable tool for risk stratification in STEMI patients undergoing pPCI.
Abstract:
Aim: Limited knowledge exists on the pathophysiological cascade beyond serum lactate's association with myocardial injury. Method: Assessed the prognostic value of lactate index on periprocedural variables and its impact on 30-day major adverse cardiovascular events (MACE) in 300 prospective ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Results: Significant correlations were observed between admission lactate and Killip class, periprocedural time intervals, postprocedure thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG; p < 0.01). Lactate levels correlated with diminished ST-deviation resolution, cardiac enzymes (CK-MB, troponin; p < 0.001; 0.004), and lower ejection fraction (p < 0.001). This relationship impacted 30-day MACE (p < 0.001). Conclusion: Hyperlactatemia in STEMI patients undergoing pPCI is associated with worse Killip class, unsatisfactory TIMI flow, MBG, larger infarct size and higher 30-day MACE. Serum lactate aids risk stratification in pPCI for STEMI patients.
More Related Videos
06:18Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm
Published on: September 17, 2021
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
