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The study aimed to explore the distribution of arterial lactate level in acute myocardial infarction (AMI) patients on admission and to identify the predictability of lactate level on major events such as cardiogenic shock or in-hospital mortality.
The study was a cross-sectional survey on 422AMI patients admitted to Vietnam National Heart Institute from Jan 2014 to Aug 2015. Arterial lactate level on admission was measured by the blood gas analyzer GEM 300. Other prognostic factors and in-hospital outcomes were collected by questionnaire.
Average arterial lactate level in AMI patients on admission was 1.98 ± 1.28 mmol/L, well correlated with age, heart rate, systolic blood pressure, Killip degree, TIMI score, left ventricular ejection fraction (LVEF), biomarker level, renal function, and glucose level on admission. Predictability of arterial lactate level for cardiogenic shock or in-hospital mortality was similar to TIMI score and significantly better than other predictors. A level above 2 mmol/l of arterial lactate level can predict cardiogenic shock with a sensitivity of 96.7% and specificity of 66.1% and predict all-cause mortality with a sensitivity of 83.3% and specificity of 66.6%. Adding killip degree, TIMI score or LVEF did not improve the predictivity of lactate level above 2 mmol/L for cardiogenic shock or mortality.
The study results highlighted the importance and usefulness of arterial lactate level in AMI patients to optimize the treatment.