Blood lactate is a predictor of short-term mortality in patients with myocardial infarction complicated by heart failure but without cardiogenic shock

• Published in: BMC cardiovascular disorders 2018-01, Vol.18 (1), p.8-8, Article 8
• Main Authors: Gjesdal, Grunde, Braun, Oscar Ö, Smith, J Gustav, Scherstén, Fredrik, Tydén, Patrik
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Adult; Aged; Aged, 80 and over; Biomarkers - blood; Cardiac and Cardiovascular Systems; Cardiogenic shock; Care and treatment; Clinical Medicine; Coronary Angiography; Female; Heart attack; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - etiology; Heart Failure - mortality; Humans; Kaplan-Meier Estimate; Kardiologi; Killip class; Klinisk medicin; Lactate; Lactic Acid - blood; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Myocardial infarction; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Patient outcomes; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Registries; Risk Assessment; Risk Factors; Shock, Cardiogenic - blood; Shock, Cardiogenic - diagnosis; Shock, Cardiogenic - etiology; Shock, Cardiogenic - mortality; Sweden - epidemiology; Time Factors; Up-Regulation
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-018-0744-1

Mortality in patients with acute myocardial infarction (AMI) has improved substantially with modern therapy including percutaneous coronary interventions (PCI) but remains high in certain subgroups such as patients presenting with overt cardiogenic shock. However, the risk for AMI in patients presenting acutely with signs of heart failure but without cardiogenic shock is less well described. We aimed to identify risk factors for mortality in AMI patients with heart failure without overt cardiogenic shock. Using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), we identified patients with operator-registered heart failure (Killip class II-IV), and evaluated predictors of mortality based on clinical factors from review of patient records. A total of 1260 unique patients with acute myocardial infarction underwent PCI in 2014, of which 77 patients (7%) showed signs of heart failure (Killip II-IV) Overall 30-day mortality in patients with Killip class II-IV was 20% (N = 15). In patients classified Killip IV (1%), 30-day mortality was 50% (N = 6). In patients presenting with mild to moderate heart failure (Killlip class II-III), 30-day mortality was 14% (N = 9). In patients with Killip class II-III, lactate ≥2.5 mmol/L was associated with 30-day mortality, whereas systolic blood pressure