Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study
BackgroundHyperlactatemia is a prognostic marker among patients with ST-segment elevation acute myocardial infarction (STEMI). However, the predictive value of lactate and the dynamic change associated with acute kidney injury (AKI) among patients with STEMI, remain poorly understood. We aimed to co...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.930202/full |
| _version_ | 1797995883440111616 |
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| author | Xi Zhou Yanlei He Long Hu Qianli Zhu Qingcheng Lin Xia Hong Weijian Huang Peiren Shan Dongjie Liang |
| author_facet | Xi Zhou Yanlei He Long Hu Qianli Zhu Qingcheng Lin Xia Hong Weijian Huang Peiren Shan Dongjie Liang |
| author_sort | Xi Zhou |
| collection | DOAJ |
| description | BackgroundHyperlactatemia is a prognostic marker among patients with ST-segment elevation acute myocardial infarction (STEMI). However, the predictive value of lactate and the dynamic change associated with acute kidney injury (AKI) among patients with STEMI, remain poorly understood. We aimed to compare single lactate values at admission (Lacadm) and 12 h after admission (Lac12h) with lactate clearance (LC) 12 h after admission for AKI prediction in patients with STEMI.MethodsA total of 1,784 patients with STEMI were included. The study endpoint was AKI occurrence during hospitalization. The predictive value of lactate levels measured at admission and 12 h after admission and LC for AKI prediction was determined using multivariate logistic regression analyses and compared with receiver operator characteristic (ROC) curve analysis.ResultsOverall, AKI was observed in 353 (19.8%) patients. In multivariate logistic regression analyses, Lacadm ≥ 4.3 mmol/L (OR: 1.53; 95% CI: 1.01–2.30), Lac12h ≥ 2.1 mmol/L (OR: 1.81; 95% CI: 1.36–2.42), and LC ≥ −7.5% (OR: 0.40; 95% CI: 0.30–0.53) were the independent predictive factors for AKI after adjusting for confounders. ROC curve analysis results revealed that Lac12h (0.639; 95% CI: 0.616–0.661) exhibited a significantly higher area under the curve (AUC) than those of Lacadm (0.551; 95% CI: 0.527–0.574) and LC (0.593; 95% CI: 0.570–0.616) in the prediction of AKI. LC (△AUC = 0.037, p < 0.001) and Lac12h (△AUC = 0.017, p = 0.029) enhanced the discrimination capacity of Mehran Risk Score (MRS) for AKI among patients undergoing emergency coronary angiography.ConclusionLac12h is more effective for AKI prediction among patients with STEMI than Lacadm and LC. Furthermore, Lac12h and LC enhance the prediction capacity of MRS for AKI among patients after emergency coronary angiography. |
| first_indexed | 2024-04-11T10:08:30Z |
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| id | doaj.art-8e23f7516911477db0ef5a8bda86c152 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T10:08:30Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-8e23f7516911477db0ef5a8bda86c1522022-12-22T04:30:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-10-01910.3389/fcvm.2022.930202930202Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort studyXi Zhou0Yanlei He1Long Hu2Qianli Zhu3Qingcheng Lin4Xia Hong5Weijian Huang6Peiren Shan7Dongjie Liang8Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaBackgroundHyperlactatemia is a prognostic marker among patients with ST-segment elevation acute myocardial infarction (STEMI). However, the predictive value of lactate and the dynamic change associated with acute kidney injury (AKI) among patients with STEMI, remain poorly understood. We aimed to compare single lactate values at admission (Lacadm) and 12 h after admission (Lac12h) with lactate clearance (LC) 12 h after admission for AKI prediction in patients with STEMI.MethodsA total of 1,784 patients with STEMI were included. The study endpoint was AKI occurrence during hospitalization. The predictive value of lactate levels measured at admission and 12 h after admission and LC for AKI prediction was determined using multivariate logistic regression analyses and compared with receiver operator characteristic (ROC) curve analysis.ResultsOverall, AKI was observed in 353 (19.8%) patients. In multivariate logistic regression analyses, Lacadm ≥ 4.3 mmol/L (OR: 1.53; 95% CI: 1.01–2.30), Lac12h ≥ 2.1 mmol/L (OR: 1.81; 95% CI: 1.36–2.42), and LC ≥ −7.5% (OR: 0.40; 95% CI: 0.30–0.53) were the independent predictive factors for AKI after adjusting for confounders. ROC curve analysis results revealed that Lac12h (0.639; 95% CI: 0.616–0.661) exhibited a significantly higher area under the curve (AUC) than those of Lacadm (0.551; 95% CI: 0.527–0.574) and LC (0.593; 95% CI: 0.570–0.616) in the prediction of AKI. LC (△AUC = 0.037, p < 0.001) and Lac12h (△AUC = 0.017, p = 0.029) enhanced the discrimination capacity of Mehran Risk Score (MRS) for AKI among patients undergoing emergency coronary angiography.ConclusionLac12h is more effective for AKI prediction among patients with STEMI than Lacadm and LC. Furthermore, Lac12h and LC enhance the prediction capacity of MRS for AKI among patients after emergency coronary angiography.https://www.frontiersin.org/articles/10.3389/fcvm.2022.930202/fulllactatelactate clearanceacute kidney injurymyocardial infarctionprediction |
| spellingShingle | Xi Zhou Yanlei He Long Hu Qianli Zhu Qingcheng Lin Xia Hong Weijian Huang Peiren Shan Dongjie Liang Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study Frontiers in Cardiovascular Medicine lactate lactate clearance acute kidney injury myocardial infarction prediction |
| title | Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study |
| title_full | Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study |
| title_fullStr | Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study |
| title_full_unstemmed | Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study |
| title_short | Lactate level and lactate clearance for acute kidney injury prediction among patients admitted with ST-segment elevation myocardial infarction: A retrospective cohort study |
| title_sort | lactate level and lactate clearance for acute kidney injury prediction among patients admitted with st segment elevation myocardial infarction a retrospective cohort study |
| topic | lactate lactate clearance acute kidney injury myocardial infarction prediction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.930202/full |
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