Correlation Between Early Arterial Lactate Levels, Arterial Bicarbonate Ion Levels, and the Lactate/Albumin Ratio and In-Hospital Mortality in Patients With Acute Myocardial Infarction Complicated With Cardiac Shock.

BACKGROUND

To investigate the connection between early arterial lactate, arterial bicarbonate ion, lactate/albumin ratio (L/A) and in-hospital mortality in patients with acute myocardial infarction complicated with cardiac shock (AMICS).

METHODS

A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of these indicators for in-hospital mortality in 395 patients with AMICS. A Kaplan‒Meier survival curve was drawn to analyze the median survival time of each subgroup. A Cox fitted proportional risk model was used to verify the association between these indicators and all-cause mortality during hospitalization.

RESULTS

ROC curve analysis revealed that the areas under the curve for arterial bicarbonate ion level, arterial lactate level, and L/A were 0.707, 0.679, and 0.670, respectively, indicating that these parameters have certain value for predicting in-hospital mortality in patients with AMICS. The Kaplan‒Meier survival curve revealed that the median survival time of the low bicarbonate ion group was shorter than that of the high bicarbonate ion group, and the median survival time of the low lactic acid group and low L/A group was longer than that of the high lactic acid group and the high L/A group. The Cox proportional risk model indicated that higher arterial bicarbonate ion levels were a protective factor for in-hospital death in AMICS patients and that higher arterial lactate levels and a higher L/A were independent risk factors.

CONCLUSION

Early arterial bicarbonate ion levels, arterial lactate levels, and the L/A were predictive of all-cause death in AMICS patients.