The peak of blood lactate during the first 24h predicts mortality in acute coronary syndrome patients under extracorporeal membrane oxygenation.

Abstract

BACKGROUND:

Parameters allowing for outcome discrimination of extracorporeal membrane oxygenation (ECMO) therapy in acute coronary syndromes (ACS) complicated by refractory cardiogenic shock (CS) and/or cardio-respiratory arrest (CA) remain elusive. We aimed at evaluating the potential prognostic roles of blood and procedural parameters associated with 30-day mortality following ECMO.

METHODS AND RESULTS:

A group of 29 patients with ACS complicated by CS and/or CA, who underwent ECMO at a single center, was retrospectively analyzed. Eighteen patients (62%) died at 30-day follow up. "Survivors" and "non-survivors" had similar demographics, clinical and biochemical characteristics at admission, except for blood lactate peak in the first 24h that was increased in non-survivors. Procedural characteristics of percutaneous coronary intervention (PCI) and ECMO were comparable in either group. The peak of blood lactate concentration predicted 30-day mortality independently of age, sex and ECMO duration. The cutoff value, determined by receiver operating characteristic (ROC) curve analysis, was found at 11mmol/l.

CONCLUSIONS:

The peak of serum lactate under ECMO in the first 24h predicted 30-day mortality in patients with ACS complicated with CS and CA.

• Authors: Fabio Rigamonti, Fabrizio Montecucco, Filippo Boroli, Florian Rey, Baris Gencer, Mustafa Cikirikcioglu, Stéphane Reverdin, Federico Carbone, Stephane Noble, Marco Roffi, Carlo Banfi, Raphael Giraud
• Journal: International journal of cardiology (Int J Cardiol) Vol. 221 Pg. 741-5 (Oct 15 2016) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 27428314 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Biomarkers
• Lactic Acid

Topics

• Acute Coronary Syndrome (blood, mortality, therapy)
• Aged
• Biomarkers (blood)
• Extracorporeal Membrane Oxygenation (mortality, trends)
• Female
• Follow-Up Studies
• Humans
• Lactic Acid (blood)
• Male
• Middle Aged
• Mortality (trends)
• Predictive Value of Tests
• Retrospective Studies
• Treatment Outcome