Associations between glycolysis related metabolites and short-term mortality after ST-elevation myocardial infarction

Prior studies found that glycolysis-related metabolic markers-particularly lactate and glucose-are associated with short-term mortality after myocardial infarction (MI). However, information on glycolysis-wide metabolite alterations and short-term post-MI mortality remains insufficient. Therefore, this study investigated the associations of glucose, lactate, pyruvate, and citrate with short-term mortality after ST-elevation myocardial infarction (STEMI).

This study was based on data from 724 STEMI patients enrolled in the population-based Augsburg Myocardial Infarction Registry. Arterial EDTA blood samples were drawn at the start of the catheterization procedure and plasma concentrations of the metabolites were quantified using a high-throughput nuclear magnetic resonance (NMR) spectroscopy platform developed by Nightingale Health (Finland). Multivariable logistic regression models were used to assess the associations between glycolysis-related metabolites and 28-day mortality. P values were adjusted for multiple testing using the false discovery rate (FDR) method.

Overall, 677 patients survived the first 28 days after hospitalization, whereas 47 died within this period. Elevated plasma levels of glucose, lactate, pyruvate, and citrate were each significantly associated with an increased risk of short-term mortality. In the multivariable logistic regression models, the strongest association was observed for glucose (OR 2.10, 95% CI 1.53-2.88, p_adj ≤ 0.001) and the weakest association for pyruvate (OR 1.60, 95% CI 1.22-2.10, p_adj = 0.001).

These findings indicate that metabolic disturbances, reflected by glycolysis-related metabolites, are associated with short-term mortality in STEMI patients, suggesting their potential prognostic value.