Objective: To evaluate the prognostic value of lactate kinetics during the first 24 hours for in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock after percutaneous coronary intervention.
Subjects and Methods: This prospective, observational, analytical study included 112 patients with acute myocardial infarction complicated by cardiogenic shock who were treated at Cho Ray Hospital from January 2024 to December 2025. The prognostic value of lactate and LC24 for in-hospital mortality was assessed using receiver operating characteristic (ROC) curve analysis and multivariable logistic regression.
Results: The mean age of the study population was 66.8 ± 13.2 years, and 73.2% were male. The median baseline lactate level was 5.1 (3.4–7.8) mmol/L. Lactate levels progressively decreased over the first 24 hours in both groups but remained significantly higher in non-survivors than in survivors (p < 0.001). At a cutoff value of 62.3% for LC24, in-hospital mortality was higher among patients with LC24 <62.3% than among those with LC24 ≥62.3% (49.3% vs. 22.2%; p = 0.004). LC24 showed good discriminatory ability for predicting in-hospital mortality, with an area under the ROC curve (AUC) of 0.803 (95% CI: 0.720–0.886; p < 0.001). After adjustment for covariates, LC24 ≥62.3% was associated with lower odds of in-hospital mortality (OR = 0.42; 95% CI: 0.18–0.97; p = 0.042).
Conclusion: Lactate kinetics during the first 24 hours have prognostic value for in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock after percutaneous coronary intervention. A 24-hour lactate clearance of ≥62.3% is associated with more favorable survival outcomes.