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| Predictive Value of Modified Level of Plasma Lactic Acid and Shock Index to Short-term Prognosis in Patients with ST-segment Elevation Myocardial Infarction |
| WANG Yanfei, ZHAO Chunsheng, NIU Xingjie, et al |
| The Affiliated Hospital of Chengde Medical College, Hebei Chengde 067000, China |
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Abstract Objective: To study the predictive value of level of plasma lactic acid (LA) and modified shock index (MSI) for 10-day outcome to short-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods:STEMI patients (n=678) were chosen from the Department of Emergency in the Affiliated Hospital of Chengde Medical College from June 2015 to June 2017. According to the level of LA level and MSI, the patients were divided into higher group (LA≥2 mmoL/L) and normal group and (LA<2 mmoL/L ), and MSI≥1.3 group and MSI<1.3 group. The general data of the patients was recorded, and major cardiac adverse events (MACE) in 10 days was reviewed and the incidence of all-cause mortality was observed, and predictive value of two indexes to short-term prognosis was analyzed by using area under curve (AUC) of receiver operating characteristic curve (ROC). Results: The difference in systolic blood pressure, diastolic blood pressure, heart rate, grades Ⅲ and Ⅳ of Killip grading had statistical significance between LA higher and normal group (P<0.05). The incidence of fatal arrhythmias and cardiogenic shock and all-cause mortality were significantly LA higher group than those in LA normal group (P<0.05). The difference in systolic blood pressure, diastolic blood pressure, heart rate, grades Ⅲ and Ⅳ of Killip grading had statistical significance between MSI≥1.3 group and MSI<1.3 group. The incidence of fatal arrhythmias and cardiogenic shock and all-cause mortality were significantly higher in MSI≥1.3 group than those in MSI<1.3 group (P<0.05). The hospital mortality was 7.52%. AUC of LA was 0.823 and AUC of MSI was 0.789 ,which had statistical significance in prediction of short-term prognosis in STEM patients. Conclusion: LA and MSI all have some predictive value to short-term prognosis in STEM patients, and LA has higher predictive value.
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2018, Vol. 24 
