The Association of Plasma Lactate With Incident Cardiovascular Outcomes

Abstract

We examined the association of plasma lactate at rest, a marker of oxidative capacity, with incident cardiovascular outcomes in 10,006 participants in the Atherosclerosis Risk in Communities (ARIC) Study visit 4 (1996-1998). We used Cox proportional-hazards models to estimate hazard ratios of incident coronary heart disease, stroke, heart failure, and all-cause mortality by quartiles of plasma lactate (Q1, ≤5.3 mg/dL; Q2, 5.4-6.6; Q3, 6.7-8.6; and Q4 ≥8.7). During a median follow-up time of 10.7 years, there were 1,105 coronary heart disease cases, 379 stroke cases, 820 heart failure cases, and 1,408 deaths. A significant graded relation between lactate level and cardiovascular events was observed in the demographically adjusted model (all P for trend < 0.001). After further adjustment for traditional and other potential confounders, the association remained significant for heart failure (Q4 vs. Q1: hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.07, 1.71) and all-cause mortality (HR = 1.27, 95% CI: 1.07, 1.51) (P for trend < 0.02 for these outcomes) but not for coronary heart disease (HR = 1.02, 95% CI: 0.84, 1.24) and stroke (HR = 1.26, 95% CI: 0.91, 1.75). The results for heart failure were robust across multiple subgroups, after further adjustment for N-terminal pro-B-type natriuretic peptide and after exclusion of participants with incident heart failure within 3 years. The independent associations of plasma lactate with heart failure and all-cause mortality suggest an important role for low resting oxidative capacity.

Effect of Schisandra chinensis Extract Supplementation on Quadriceps Muscle Strength and Fatigue in Adult Women: A Randomized, Double-Blind, Placebo-Controlled Trial

“…The normal range of lactic acid at rest is not yet clear. The normal range for lactate in the study of Matsushita et al was 2.3-5.3 mg/dL [20], which was also similar in Juraschek et al's study [46]. However, in our subjects, the lactate level at rest was as high as 8.7 mg/dL.…”

“…In other cross-sectional and follow-up studies, a high lactate level at rest was associated with chronic diseases such as type 2 diabetes and hypertension [19,46]. It was associated with a high risk of coronary heart disease (CHD), stroke, and all-cause mortality [20].…”

“…A follow-up study by Matsushita et al reported that resting lactate levels were associated with body fat, blood pressure, serum lipids, insulin, and high sensitivity C-reactive protein in adults [20]. In other cross-sectional and follow-up studies, a high lactate level at rest was associated with chronic diseases such as type 2 diabetes and hypertension [19,46].…”

“…Blood lactate (BL) levels have been widely used as an indicator of muscle fatigue during the physical stress of the human body, such as acute exercise [16][17][18]. However, reliable cross-sectional and follow-up studies in adults have shown that high levels of resting BL are associated with a high risk of type 2 diabetes, CHD, and stroke [19,20].…”

Targeted Metabolomic Profiling of Plasma and Survival in Heart Failure Patients

“…An early application of metabolomics profiling has been cardiovascular disease (5–7) with a focus on coronary syndromes (8–10). Similarly, there is growing data derived from the setting of HF, in which specific plasma metabolite levels were reported to be associated with incident disease or risk of death (11–15). More recently, a few systematic evaluations of the metabolites in HF were published which further support the overall hypothesis that circulating metabolites may be deranged in the setting of HF and indeed may reflect the underlying disease state (16–18).…”