Hyperlactatemia and the Outcome of Type 2 Diabetic Patients Suffering Acute Myocardial Infarction

Aleksandar, Jovanovic N.; Perić, Vladan; Marković-Jovanović, Snežana; Stolić, Radojica; Mitić, Jadranka; Smilić, Tanja

doi:10.1155/2016/6901345

Cited by 20 publications

(19 citation statements)

References 28 publications

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“…To our knowledge, AMI is usually associated with the effect of tissue oxygenation, which may be due to insufficient oxygen supply or inhibition of mitochondrial pyruvate dehydrogenase complex. 20 When oxygen supply exceeds the capacity of diseased vessels, hypoxia forces myocardium to change from an aerobic metabolism to an anaerobic metabolism, leading to lactate accumulation. 10 As previously reported, lactate was the strongest predictor as a determinant of global tissue hypoxaemia.…”

Section: Discussionmentioning

confidence: 99%

The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention

Yan¹,

Wang²,

Tang³

et al. 2021

IJGM

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Objective The association of lactate and contrast-induced acute kidney injury (CI-AKI) has not been well established. This prospective study was planned to identify the effects of lactate level on the occurrence of CI-AKI and long-term prognosis with acute myocardial infarction (AMI) patients undergoing emergency percutaneous coronary intervention (PCI). Methods A total of 280 patients with AMI who underwent emergency PCI were selected from March 2018 to March 2019. A receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off value of lactate on predicting CI-AKI after PCI. A multivariable logistic regression model was used to explore the significant predictors that might affect the occurrence of CI-AKI after univariate analysis. The primary endpoints were clinical outcomes including events: a combined endpoint of major adverse cardiovascular events, re-hospitalization due to heart failure, and worsening renal function. The Cox regression model was further used to analyze the predictors of the long-term prognosis after PCI. Results Among the 280 patients, 64 patients (22.9%) developed CI-AKI after emergency PCI procedure. Multivariable logistic regression analysis revealed that baseline lactate level was the independent risk factor for the development of CI-AKI (OR, 3.657; 95% CI, 2.237–5.978; p <0.001). The area under the ROC curve for predicting CI-AKI of lactate was 0.786, and the optimum cut-off point of lactate was 3.02 mmol/L, with sensitivity of 65.6% and specificity of 85.2%. The incidence of primary endpoints in the high lactate group (lactate ≥3.02mmol/L) was significantly increased compared with the control group [26.3% (42/160) vs 15.8% (19/120), χ 2 =4.430, p =0.035]. Cox regression analysis also confirmed high lactate was an independent predictor for primary endpoint outcomes at 1-year follow-up (HR, 1.916; 95% CI, 1.118–3.285; p =0.018). Conclusion Our study demonstrates that baseline high lactate levels may be associated with an increased risk of CI-AKI and are the important predictors of long-term poor cardiorenal outcomes in AMI patients undergoing emergency PCI.

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Section: Discussionmentioning

confidence: 99%

The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention

Yan¹,

Wang²,

Tang³

et al. 2021

IJGM

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“…Furthermore, due to increased basal plasma lactate levels, the postprandial change in lactate following a meal is significantly reduced in T2D. Thus, this reduction in meal-induced lactate response may contribute to postprandial hyperglucagonemia in T2D patients [ 82 ] due to reduced lactate inhibition of GCG secretion. GCG signaling also increases hepatic lactate output [ 83 ] and thus in T2D, elevated GCG levels may contribute to increased lactate levels.…”

Section: Discussionmentioning

confidence: 99%

Lactate activation of α-cell KATP channels inhibits glucagon secretion by hyperpolarizing the membrane potential and reducing Ca2+ entry

Zaborska

Dadi

Dickerson

et al. 2020

Molecular Metabolism

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Objective Elevations in pancreatic α-cell intracellular Ca 2+ ([Ca 2+ ] i ) lead to glucagon (GCG) secretion. Although glucose inhibits GCG secretion, how lactate and pyruvate control α-cell Ca 2+ handling is unknown. Lactate enters cells through monocarboxylate transporters (MCTs) and is also produced during glycolysis by lactate dehydrogenase A (LDHA), an enzyme expressed in α-cells. As lactate activates ATP-sensitive K + (K ATP ) channels in cardiomyocytes, lactate may also modulate α-cell K ATP . Therefore, this study investigated how lactate signaling controls α-cell Ca 2+ handling and GCG secretion. Methods Mouse and human islets were used in combination with confocal microscopy, electrophysiology, GCG immunoassays, and fluorescent thallium flux assays to assess α-cell Ca 2+ handling, V m , K ATP currents, and GCG secretion. Results Lactate-inhibited mouse (75 ± 25%) and human (47 ± 9%) α-cell [Ca 2+ ] i fluctuations only under low-glucose conditions (1 mM) but had no effect on β- or δ-cells [Ca 2+ ] i . Glyburide inhibition of K ATP channels restored α-cell [Ca 2+ ] i fluctuations in the presence of lactate. Lactate transport into α-cells via MCTs hyperpolarized mouse (14 ± 1 mV) and human (12 ± 1 mV) α-cell V m and activated K ATP channels. Interestingly, pyruvate showed a similar K ATP activation profile and α-cell [Ca 2+ ] i inhibition as lactate. Lactate-induced inhibition of α-cell [Ca 2+ ] i influx resulted in reduced GCG secretion in mouse (62 ± 6%) and human (43 ± 13%) islets. Conclusions These data demonstrate for the first time that lactate entry into α-cells through MCTs results in K ATP activation, V m hyperpolarization, reduced [Ca 2+ ] i , and inhibition of GCG secretion. Thus, taken together, these data indicate that lactate either within α-cells and/or elevated in serum could serve as important modulators of α-cell function.

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“…15,16 Data from early study demonstrated that metabolic acidosis and lactic acidosis are important factors in causing the high mortality from acute myocardial infarction. 17 However, little data is available on the association of acidemia with short-term mortality of AMI patients. Here, we retrospectively selected 972 AMI patients admitted in intensive care unit (ICU) based on the Medical Information Mart for Intensive Care (MIMIC) III, aiming to detect the association of acidemia with the 30-day mortality and 90-day mortality of AMI patients.…”

Section: Introductionmentioning

confidence: 99%

Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database

Zhang

Guan

Líu

2020

Clin Appl Thromb Hemost

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Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients ( P < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients ( P < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, P = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, P = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.

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Hyperlactatemia and the Outcome of Type 2 Diabetic Patients Suffering Acute Myocardial Infarction

Cited by 20 publications

References 28 publications

The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention

The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention

Lactate activation of α-cell KATP channels inhibits glucagon secretion by hyperpolarizing the membrane potential and reducing Ca2+ entry

Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database

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