Abstract
Little is known about causality and the pathological mechanism underlying the association of serum lactate with myocardial injury in patients with acute myocardial infarction (AMI). We evaluated data from 360 AMI patients undergoing percutaneous coronary intervention (PCI) using cardiovascular magnetic resonance imaging (CMR). Of these, 119 patients had serum lactate levels > 2.5 mmol/L on admission (high serum lactate group), whereas 241 patients had serum lactate levels ≤ 2.5 mmol/L (low serum lactate group). We compared the myocardial infarct size assessed by CMR between the two groups and performed inverse probability of treatment weighting (IPTW). In CMR analysis, myocardial infarct size was significantly greater in the high serum lactate group than in the low serum lactate group (22.0 ± 11.4% in the high serum lactate group vs. 18.9 ± 10.5% in the low serum lactate group; p = 0.011). The result was consistent after IPTW adjustment (21.5 ± 11.1% vs. 19.2 ± 10.4%; p = 0.044). In multivariate analysis, high serum lactate was associated with larger myocardial infarct (odds ratio 1.59; 95% confidence interval 1.00–2.51; p = 0.048). High serum lactate could predict advanced myocardial injury in AMI patients undergoing PCI.
Highlights
Acute myocardial infarction (AMI) is the most frequent cause of cardiogenic shock, and patients with AMI readily exhibit increased serum lactate levels [1,2]
We evaluated an association between elevated levels of serum lactate and myocardial injury assessed by Cardiovascular magnetic resonance imaging (CMR) in AMI patients undergoing percutaneous coronary intervention (PCI)
The association between serum lactate level and myocardial injury was investigated The association between serum lactate level and myocardial injury was investigated in patients with AMI using CMR markers of myocardial and microvascular damage
Summary
Acute myocardial infarction (AMI) is the most frequent cause of cardiogenic shock, and patients with AMI readily exhibit increased serum lactate levels [1,2]. Because serum lactate levels reflect hemodynamic status, and increased serum lactate indicates decreased systemic oxygen delivery or tissue hypoperfusion, serum lactate is a prognostic marker in critically ill patients in various forms of shock [2,3]. >2.5–4.0 mmol/L and a lactate < 2 mmol/L (47.4% vs 26.5% vs 19.6%; p < 0.0001), suggesting the negative correlation of serum lactate with clinical outcomes among critically ill patients. Cardiovascular magnetic resonance imaging (CMR) can assess the extent of myocardial injury, providing valuable insight into the effects of serum lactate level in AMI patients [6,7]. We evaluated an association between elevated levels of serum lactate and myocardial injury assessed by CMR in AMI patients undergoing percutaneous coronary intervention (PCI)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
