Abstract 9974: Initial Serum Lactate Predicts Mortality After Cardiac Catheterization Following Cardiac Arrest

IntroductionCardiac arrest (CA) is associated with low survival despite resuscitation and return of spontaneous circulation. Electrocardiograms in these patients are challenging to interpret and may suggest myocardial ischemia as the inciting event. We sought to investigate the impact of initial ser...

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Veröffentlicht in:Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A9974-A9974
Hauptverfasser: Guo, Chen-yu C, Rosenberg, Russell, Schreyer, Kraftin, Bashir, Riyaz, O’Murchu, Brian, Aggarwal, Vikas, Weiss, Debbie, DeAngelis, Michael, Edmundowicz, Daniel, O’Neill, Brian
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container_end_page A9974
container_issue Suppl_1 Suppl 1
container_start_page A9974
container_title Circulation (New York, N.Y.)
container_volume 140
creator Guo, Chen-yu C
Rosenberg, Russell
Schreyer, Kraftin
Bashir, Riyaz
O’Murchu, Brian
Aggarwal, Vikas
Weiss, Debbie
DeAngelis, Michael
Edmundowicz, Daniel
O’Neill, Brian
description IntroductionCardiac arrest (CA) is associated with low survival despite resuscitation and return of spontaneous circulation. Electrocardiograms in these patients are challenging to interpret and may suggest myocardial ischemia as the inciting event. We sought to investigate the impact of initial serum lactate on survival in post CA patients referred to the cath lab.HypothesisInitial serum lactate predicts mortality after cardiac catheterization following cardiac arrestMethodsWe retrospectively reviewed patients at our institution taken for urgent catheterization between January 2014 and September 2018 after CA. Patients were identified through activation of the cath lab for a STEMI alert or urgent case. Characteristics of survivors and non-survivors were compared.Results384 patients were referred urgently to the cath lab during this period, 50 with prior CA. The mean age of the cohort was 57. 66% were men, 40% had a history of coronary artery disease. Overall survival was 40%. Primary causes of death were cardiogenic shock (30%), CA (26.7%), and anoxic brain injury (20%). Survival in patients who underwent coronary intervention compared with those who did not was similar (45.5% vs 29.4%; p=0.27). Mean lactate level in survivors vs non-survivors was 4.7±3.8 and 9.8±4.7 mmol/L, respectively (p
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Electrocardiograms in these patients are challenging to interpret and may suggest myocardial ischemia as the inciting event. We sought to investigate the impact of initial serum lactate on survival in post CA patients referred to the cath lab.HypothesisInitial serum lactate predicts mortality after cardiac catheterization following cardiac arrestMethodsWe retrospectively reviewed patients at our institution taken for urgent catheterization between January 2014 and September 2018 after CA. Patients were identified through activation of the cath lab for a STEMI alert or urgent case. Characteristics of survivors and non-survivors were compared.Results384 patients were referred urgently to the cath lab during this period, 50 with prior CA. The mean age of the cohort was 57. 66% were men, 40% had a history of coronary artery disease. Overall survival was 40%. Primary causes of death were cardiogenic shock (30%), CA (26.7%), and anoxic brain injury (20%). Survival in patients who underwent coronary intervention compared with those who did not was similar (45.5% vs 29.4%; p=0.27). Mean lactate level in survivors vs non-survivors was 4.7±3.8 and 9.8±4.7 mmol/L, respectively (p&lt;0.05). When divided into subgroups of low (&lt;4.5 mmol/L) medium (4.5 to 9 mmol/L) and high (&gt;9 mmol/L) serum lactate, survival to discharge was 75%, 29.4%, and 17.6%, respectively (p&lt;0.05).ConclusionsIn patients who present to the cath lab post CA, routine measurement of serum lactate is a useful adjunct to help risk stratify to poor outcome.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/circ.140.suppl_1.9974</identifier><language>eng</language><publisher>by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><ispartof>Circulation (New York, N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A9974-A9974</ispartof><rights>2019 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Guo, Chen-yu C</creatorcontrib><creatorcontrib>Rosenberg, Russell</creatorcontrib><creatorcontrib>Schreyer, Kraftin</creatorcontrib><creatorcontrib>Bashir, Riyaz</creatorcontrib><creatorcontrib>O’Murchu, Brian</creatorcontrib><creatorcontrib>Aggarwal, Vikas</creatorcontrib><creatorcontrib>Weiss, Debbie</creatorcontrib><creatorcontrib>DeAngelis, Michael</creatorcontrib><creatorcontrib>Edmundowicz, Daniel</creatorcontrib><creatorcontrib>O’Neill, Brian</creatorcontrib><title>Abstract 9974: Initial Serum Lactate Predicts Mortality After Cardiac Catheterization Following Cardiac Arrest</title><title>Circulation (New York, N.Y.)</title><description>IntroductionCardiac arrest (CA) is associated with low survival despite resuscitation and return of spontaneous circulation. Electrocardiograms in these patients are challenging to interpret and may suggest myocardial ischemia as the inciting event. We sought to investigate the impact of initial serum lactate on survival in post CA patients referred to the cath lab.HypothesisInitial serum lactate predicts mortality after cardiac catheterization following cardiac arrestMethodsWe retrospectively reviewed patients at our institution taken for urgent catheterization between January 2014 and September 2018 after CA. Patients were identified through activation of the cath lab for a STEMI alert or urgent case. Characteristics of survivors and non-survivors were compared.Results384 patients were referred urgently to the cath lab during this period, 50 with prior CA. The mean age of the cohort was 57. 66% were men, 40% had a history of coronary artery disease. Overall survival was 40%. Primary causes of death were cardiogenic shock (30%), CA (26.7%), and anoxic brain injury (20%). Survival in patients who underwent coronary intervention compared with those who did not was similar (45.5% vs 29.4%; p=0.27). Mean lactate level in survivors vs non-survivors was 4.7±3.8 and 9.8±4.7 mmol/L, respectively (p&lt;0.05). When divided into subgroups of low (&lt;4.5 mmol/L) medium (4.5 to 9 mmol/L) and high (&gt;9 mmol/L) serum lactate, survival to discharge was 75%, 29.4%, and 17.6%, respectively (p&lt;0.05).ConclusionsIn patients who present to the cath lab post CA, routine measurement of serum lactate is a useful adjunct to help risk stratify to poor outcome.</description><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNqdjttKxDAURYMoWC-fIOQHUs9p0inxrQwOCiMI-l5iJmOjsRmSU4p-vRHED_BhsziXBZuxK4QacYXX1idbo4I6z4dDGLDWulNHrMK2UUK1Uh-zCgC06GTTnLKznN_KuJJdW7Gpf8mUjCX-I93w-8mTN4E_uTR_8G05GHL8Mbmdt5T5Q0xkgqdP3u_JJb42aeeNLaTRlYX_MuTjxDcxhLj46fXvo0_JZbpgJ3sTsrv85TlTm9vn9Z1YYih6fg_z4tIwOhNoHEpLkICdaAA1YokAwFbKf2rfFAFaNQ</recordid><startdate>20191119</startdate><enddate>20191119</enddate><creator>Guo, Chen-yu C</creator><creator>Rosenberg, Russell</creator><creator>Schreyer, Kraftin</creator><creator>Bashir, Riyaz</creator><creator>O’Murchu, Brian</creator><creator>Aggarwal, Vikas</creator><creator>Weiss, Debbie</creator><creator>DeAngelis, Michael</creator><creator>Edmundowicz, Daniel</creator><creator>O’Neill, Brian</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><scope/></search><sort><creationdate>20191119</creationdate><title>Abstract 9974: Initial Serum Lactate Predicts Mortality After Cardiac Catheterization Following Cardiac Arrest</title><author>Guo, Chen-yu C ; Rosenberg, Russell ; Schreyer, Kraftin ; Bashir, Riyaz ; O’Murchu, Brian ; Aggarwal, Vikas ; Weiss, Debbie ; DeAngelis, Michael ; Edmundowicz, Daniel ; O’Neill, Brian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-wolterskluwer_health_00003017-201911191-001533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Guo, Chen-yu C</creatorcontrib><creatorcontrib>Rosenberg, Russell</creatorcontrib><creatorcontrib>Schreyer, Kraftin</creatorcontrib><creatorcontrib>Bashir, Riyaz</creatorcontrib><creatorcontrib>O’Murchu, Brian</creatorcontrib><creatorcontrib>Aggarwal, Vikas</creatorcontrib><creatorcontrib>Weiss, Debbie</creatorcontrib><creatorcontrib>DeAngelis, Michael</creatorcontrib><creatorcontrib>Edmundowicz, Daniel</creatorcontrib><creatorcontrib>O’Neill, Brian</creatorcontrib><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guo, Chen-yu C</au><au>Rosenberg, Russell</au><au>Schreyer, Kraftin</au><au>Bashir, Riyaz</au><au>O’Murchu, Brian</au><au>Aggarwal, Vikas</au><au>Weiss, Debbie</au><au>DeAngelis, Michael</au><au>Edmundowicz, Daniel</au><au>O’Neill, Brian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abstract 9974: Initial Serum Lactate Predicts Mortality After Cardiac Catheterization Following Cardiac Arrest</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><date>2019-11-19</date><risdate>2019</risdate><volume>140</volume><issue>Suppl_1 Suppl 1</issue><spage>A9974</spage><epage>A9974</epage><pages>A9974-A9974</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><abstract>IntroductionCardiac arrest (CA) is associated with low survival despite resuscitation and return of spontaneous circulation. Electrocardiograms in these patients are challenging to interpret and may suggest myocardial ischemia as the inciting event. We sought to investigate the impact of initial serum lactate on survival in post CA patients referred to the cath lab.HypothesisInitial serum lactate predicts mortality after cardiac catheterization following cardiac arrestMethodsWe retrospectively reviewed patients at our institution taken for urgent catheterization between January 2014 and September 2018 after CA. Patients were identified through activation of the cath lab for a STEMI alert or urgent case. Characteristics of survivors and non-survivors were compared.Results384 patients were referred urgently to the cath lab during this period, 50 with prior CA. The mean age of the cohort was 57. 66% were men, 40% had a history of coronary artery disease. Overall survival was 40%. Primary causes of death were cardiogenic shock (30%), CA (26.7%), and anoxic brain injury (20%). Survival in patients who underwent coronary intervention compared with those who did not was similar (45.5% vs 29.4%; p=0.27). Mean lactate level in survivors vs non-survivors was 4.7±3.8 and 9.8±4.7 mmol/L, respectively (p&lt;0.05). When divided into subgroups of low (&lt;4.5 mmol/L) medium (4.5 to 9 mmol/L) and high (&gt;9 mmol/L) serum lactate, survival to discharge was 75%, 29.4%, and 17.6%, respectively (p&lt;0.05).ConclusionsIn patients who present to the cath lab post CA, routine measurement of serum lactate is a useful adjunct to help risk stratify to poor outcome.</abstract><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><doi>10.1161/circ.140.suppl_1.9974</doi></addata></record>
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title Abstract 9974: Initial Serum Lactate Predicts Mortality After Cardiac Catheterization Following Cardiac Arrest
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