Changes in lactate levels before and after AMI intervention therapy and their correlation with coronary microcirculation disorders
[Objective]To observe the changes in lactic acid(LAC)levels and their correlation with coronary microvascular dysfunction(CMD)in acute myocardial infarction(AMI)patients before and after percutaneous coronary intervention(PCI)treatment.[Methods]This study selected 125 AMI patients admitted between October 2020 and January 2023 as the study subjects,and a retrospective study was conducted.All patients underwent PCI treatment,and the changes in LAC levels and improvement in coronary microcirculation before and after treatment were recorded and compared.The Spearman correlation coefficient was used to test the association between LAC and coronary microcirculation function.Based on whether to merge CMD,the enrolled patients were divided into a normal group and an abnormal group.The differences in LAC levels between the two groups were compared,and the predictive efficacy of LAC on postoperative CMD was verified by plotting the subject's work characteristic curve.[Results]The LAC of 125 AMI patients 24 hours after PCI treatment was 0.71±0.11 mmol/L,which was lower than(1.05±0.32 mmol/L,1.52±0.36 mmol/L,2.26±0.34 mmol/L)at 12 hours,6 hours after treatment,and before treatment(P＜0.05).After treatment,the coronary flow reserve(CFR)of 125 patients was 2.55±0.37,fractional flow reserve(FFR)was 0.82±0.31,both higher than before treatment(1.77±0.26,0.66±0.21),the index of microcirculatory resistance(IMR)was 40.33±5.27,lower than before treatment(43.42±5.18)(P＜0.05).After Spearman correlation coefficient test,LAC levels were negatively correlated with CFR and FFR,and positively correlated with IMR.According to statistics,after PCI treatment in 125 patients,30 cases had CMD and 95 cases did not.The LAC level in the abnormal group was 1.61±0.44 mmol/L,which was higher than that in the normal group(0.88±0.14 mmol/L)(P＜0.05).After ROC validation,the AUC of LAC for predicting CMD after PCI in AMI was 0.862.[Conclusion]The LAC level of AMI after PCI treatment will gradually decrease with the increase of CFR and FFR,and will gradually decrease with the decrease of IMR.LAC has high predictive power for postoperative CMD after PCI.
万方数据
维普
