The role of serum lactate in evaluation of coronary slow flow in patients with acute myocardial infarction underwent percutaneous coronary intervention
Chen Yu
Li Rongshan
Wang Yong
Zhuo Liuan
Yin Jianbin
Chen Huisheng
Li Qihua
Wei Shujing
Yang Jin
Abstract：Objective To investigate the value of blood lactate (LA) level and lactate clearance rate in prognostic assessment in acute ST-segment myocardial infarction (STEMI) patients with coronary slow flow (CSF) underwent primary percutaneous coronary intervention (PCI). Methods From March 2016 to June 2017, 91 STEMI patients underwent primary PCI were enrolled. According to the correct of TIMI (thrombolysis in myocardial infarction) frame count (CTFC) of the infarct related artery(IRA) ,71 patients of TIMI 3 were selected as control group, 20 patients of TIMI 0-2 were selected as CSF group. The blood LA, troponine I (cTnI), creatine kinase-MB (CKMB), N-terminal pro-B-type natriuretic peptide (NT-proBNP), hypersensitivity C reactive protein (hsCRP), left ventricular ejection fraction (LVEF)and major adverse cardiovascular events (MACEs) were compared before PCI and at 6 h, 24 h and 7 d after PCI. Results The results showed that arterial blood lactate value at 6 h and 7 d after PCI of CSF group were significantly higher than that of the control group, the difference was statistically significant (4.36±3.02 vs. 3.27±1.42, 3.45±2.27 vs. 2.39±0.79, P<0.05). There was no significant difference of arterial blood lactate level before and 24 h after PCI (3.63±2.37 vs. 3.11±1.52, 3.51±0.64 vs. 3.11±0.94, P>0.05). Compared with control group, cTnI peak level, the level of CKMB at 7th day and hsCRP in CSF group were higher, while the value of LVEF was lower (P>0.05). A significant difference was found with respect of in-hospital death and MACEs between for CSF group with control group (P<0.05). There was no significant difference of the LA clearance rate in CSF group (P>0.05). The level of LA in hospital was significantly related to CKMB at 7th day, NT-proBNP, LVEF, and cardiac care unit (CCU) mortality in CSF group. Conclusion Perioperative lactate monitoring can be used as an effective predictor of disease progression and prognosis in patients with myocardial infarction with coronary microcirculatory disturbances.
Keywords：LactateLactate clearanceAcute myocardial infarctionCoronary slow flow
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 432-435 )