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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
ARIAS, Aníbal M. et al. Plasmatic pattern and clinical outcomes of lactic acid in heart transplantation. Arch. Cardiol. Méx. [online]. 2016, vol.86, n.4, pp.313-318. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2016.04.002.
Introduction
It is not well established the prognostic value of elevated lactic acid after heart transplantation.
Objective
To evaluate the plasmatic pattern and the prognostic value of elevated lactate after heart transplantation.
Methods
One-hundred and twenty seven patients were included between 2011 and 2014, 71 comprising the transplantation group and 56 the control group, represented by on pump coronary artery by-pass surgery patients. Lactic acid levels were compared between groups before, within and after surgery upon Coronary Care Unit admission, at 6, 12 and 24 h. In addition, in the transplantation group univariate and bivariate analysis were performed between lactic acid levels and in-hospital mortality.
Results
The mean age of the entire cohort was 57 years. Among transplanted patients, lactic acid levels were significantly higher over control group: within the surgery; and after surgery (P<.001), but not before surgery (P=.143; unadjusted comparisons). In transplanted patients, lactic acid levels were significantly associated with in-hospital mortality during surgery, at admission, and thereafter but not before surgery. Lactic acid at admission was associated with in-hospital mortality after adjustment of postoperative cardiac output (P=.011), ≥ 2 inotropic drug support within 24 h (P=.033), glycemic level at admission (P=.004), age ≥ 60 years (P=.015), on pump time (P=.027), and pH (P=.017).
Conclusions
Acid lactic levels were higher in transplanted patients than in the control group and was associated to higher in-hospital mortality.
Keywords : Lactic acid; Heart failure; Heart transplantation; Argentina.