Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock
In patients with cardiogenic shock (CS) due to myocardial infarction, elevated lactate levels are known to be negative predictors. Studies regarding the prognostic impact in patients with CS complicated by out-of-hospital cardiac arrest (OHCA) are limited. Two hundred and sixty-three consecutive pat...
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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/24/7295 |
| _version_ | 1797457076556922880 |
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| author | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin |
| author_facet | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin |
| author_sort | Jonas Rusnak |
| collection | DOAJ |
| description | In patients with cardiogenic shock (CS) due to myocardial infarction, elevated lactate levels are known to be negative predictors. Studies regarding the prognostic impact in patients with CS complicated by out-of-hospital cardiac arrest (OHCA) are limited. Two hundred and sixty-three consecutive patients with CS were included. The prognostic value of lactate on days 1, 2, 3, 4 and 8 was tested stratified by OHCA and non-OHCA. Statistical analyses included the univariable <i>t</i>-test, Spearman’s correlation, C-statistics, Kaplan–Meier analyses, as well as multivariable mixed analysis of variance (ANOVA) and Cox proportional regression analyses. The primary endpoint of all-cause mortality occurred in 49.4% of the non-OHCA group and in 63.4% of the OHCA group. Multivariable regression models showed an association of lactate values with 30-day all-cause mortality in the non-OHCA (<i>p</i> = 0.024) and OHCA groups (<i>p</i> = 0.001). In Kaplan–Meier analyses, patients with lactate levels ≥ 4 mmol/L (log-rank <i>p</i> = 0.001) showed the highest risk for 30-day all-cause mortality in the non-OHCA as well as in the OHCA group. However, in C-statistics lactate on days 1 and 8 had a better discrimination for 30-day all-cause mortality in the OHCA group compared to the non-OHCA group. In conclusion, patients presenting with CS lactate levels showed a good prognostic performance, with and without OHCA. Especially, lactate levels on days 1 and 8 were more accurate in the discrimination for all-cause mortality in CS-patients with OHCA. |
| first_indexed | 2024-03-09T16:17:00Z |
| format | Article |
| id | doaj.art-9ed0202810ee4fec944c24b6cc3f3697 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:17:00Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9ed0202810ee4fec944c24b6cc3f36972023-11-24T15:43:04ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011124729510.3390/jcm11247295Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic ShockJonas Rusnak0Tobias Schupp1Kathrin Weidner2Marinela Ruka3Sascha Egner-Walter4Jan Forner5Thomas Bertsch6Maximilian Kittel7Kambis Mashayekhi8Péter Tajti9Mohamed Ayoub10Michael Behnes11Ibrahim Akin12Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyInstitute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, GermanyInstitute for Clinical Chemistry, Faculty of Medicine Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Internal Medicine and Cardiology, Mediclin Heart Centre Lahr, 77933 Lahr, GermanyGottsegen György National Cardiovascular Center, 1096 Budapest, HungaryDivision of Cardiology and Angiology, Heart Center University of Bochum, 32545 Bad Oeynhausen, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyIn patients with cardiogenic shock (CS) due to myocardial infarction, elevated lactate levels are known to be negative predictors. Studies regarding the prognostic impact in patients with CS complicated by out-of-hospital cardiac arrest (OHCA) are limited. Two hundred and sixty-three consecutive patients with CS were included. The prognostic value of lactate on days 1, 2, 3, 4 and 8 was tested stratified by OHCA and non-OHCA. Statistical analyses included the univariable <i>t</i>-test, Spearman’s correlation, C-statistics, Kaplan–Meier analyses, as well as multivariable mixed analysis of variance (ANOVA) and Cox proportional regression analyses. The primary endpoint of all-cause mortality occurred in 49.4% of the non-OHCA group and in 63.4% of the OHCA group. Multivariable regression models showed an association of lactate values with 30-day all-cause mortality in the non-OHCA (<i>p</i> = 0.024) and OHCA groups (<i>p</i> = 0.001). In Kaplan–Meier analyses, patients with lactate levels ≥ 4 mmol/L (log-rank <i>p</i> = 0.001) showed the highest risk for 30-day all-cause mortality in the non-OHCA as well as in the OHCA group. However, in C-statistics lactate on days 1 and 8 had a better discrimination for 30-day all-cause mortality in the OHCA group compared to the non-OHCA group. In conclusion, patients presenting with CS lactate levels showed a good prognostic performance, with and without OHCA. Especially, lactate levels on days 1 and 8 were more accurate in the discrimination for all-cause mortality in CS-patients with OHCA.https://www.mdpi.com/2077-0383/11/24/7295cardiogenic shocklactateprognosismortalityOHCA |
| spellingShingle | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock Journal of Clinical Medicine cardiogenic shock lactate prognosis mortality OHCA |
| title | Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock |
| title_full | Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock |
| title_fullStr | Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock |
| title_full_unstemmed | Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock |
| title_short | Impact of Lactate on 30-Day All-Cause Mortality in Patients with and without Out-of-Hospital Cardiac Arrest Due to Cardiogenic Shock |
| title_sort | impact of lactate on 30 day all cause mortality in patients with and without out of hospital cardiac arrest due to cardiogenic shock |
| topic | cardiogenic shock lactate prognosis mortality OHCA |
| url | https://www.mdpi.com/2077-0383/11/24/7295 |
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