Pulmonary Embolism Patients with High Plasma Lactate Levels Are Likelier to Die
Patients with acute pulmonary embolism who died had “significantly higher” levels of plasma lactate than survivors did. A study published online yesterday in Annals of Emergency Medicine is the first showing an association between high plasma lactate levels and short-term mortality in patients with acute pulmonary embolism, independent of the presence of shock or of markers of right-sided ventricular dysfunction or injury markers (“Prognostic Value of Plasma Lactate Levels Among Patients with Acute Pulmonary Embolism: The Thrombo-Embolism Lactate Outcome Study (TELOS)”)
“Our findings could represent a significant advance in short-term assessment and treatment of pulmonary embolism, the third leading cause of death due to cardiovascular disease,” said lead study author Simone Vanni, MD, Ph.D., of Azienda Ospedaliero-Universitaria Careggi in Florence, Italy. “Mortality progressively increased with higher plasma lactate levels. It remains to be seen whether plasma lactate levels could guide therapy for patients with acute pulmonary embolism.”
Researchers enrolled 270 patients with pulmonary embolism (PE) in the study and conducted 30-day follow up assessments. At 30 days, 37 patients had either died or experienced PE-related clinical complications. Patients who died had significantly higher mean plasma lactate levels (4.7 millimeters per liter) than survivors (1.6 millimeters per liter). Patients who died only due to pulmonary embolism – as opposed to cancer or other complications – had significantly higher levels of plasma lactate: 5.5 millimeters per liter v. 1.6 millimeters per liter for survivors.
“Patients with acute pulmonary embolism and high plasma lactate levels should undergo strict medical surveillance and monitoring,” said Dr. Vanni. “A multi-center prospective study is now warranted to confirm or to extend our knowledge about the prognostic value of plasma lactate levels in these patients.”
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