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dc.contributor.authorEbner, Matthias
dc.contributor.authorPagel, Charlotta F
dc.contributor.authorSentler, Carmen
dc.contributor.authorHarjola, Veli-Pekka
dc.contributor.authorBueno, Hector 
dc.contributor.authorLerchbaumer, Markus H
dc.contributor.authorStangl, Karl
dc.contributor.authorPieske, Burkert
dc.contributor.authorHasenfuß, Gerd
dc.contributor.authorKonstantinides, Stavros V
dc.contributor.authorLankeit, Mareike
dc.identifier.citationEur J Intern Med. 2021; 86:25-31es_ES
dc.description.abstractArterial lactate is an established risk marker in patients with pulmonary embolism (PE). However, its clinical applicability is limited by the need of an arterial puncture. In contrast, venous lactate can easily be measured from blood samples obtained via routine peripheral venepuncture. We investigated the prognostic value of venous lactate with regard to in-hospital adverse outcomes and mortality in 419 consecutive PE patients enrolled in a single-center registry between 09/2008 and 09/2017. An optimised venous lactate cut-off value of 3.3 mmol/l predicted both, in-hospital adverse outcome (OR 11.0 [95% CI 4.6-26.3]) and all-cause mortality (OR 3.8 [95%CI 1.3-11.3]). The established cut-off value for arterial lactate (2.0 mmol/l) and the upper limit of normal for venous lactate (2.3 mmol/l) had lower prognostic value for adverse outcomes (OR 3.6 [95% CI 1.5-8.7] and 5.7 [95% CI 2.4-13.6], respectively) and did not predict mortality. If added to the 2019 European Society of Cardiology (ESC) algorithm, venous lactate <2.3 mmol/l was associated with a high negative predictive value (0.99 [95% CI 0.97-1.00]) for adverse outcomes in intermediate-low-risk patients, whereas levels ≥3.3 mmol/l predicted adverse outcomes in the intermediate-high-risk group (OR 5.2 [95% CI 1.8-15.0]). Venous lactate above the upper limit of normal was associated with increased risk for adverse outcomes and an optimised cut-off value of 3.3 mmol/l predicted adverse outcome and mortality. Adding venous lactate to the 2019 ESC algorithm may improve risk stratification. Importantly, the established cut-off value for arterial lactate has limited specificity in venous samples and should not be used.es_ES
dc.description.sponsorshipThis study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503). The authors are responsible for the contents of this publication. CNIC is supported by the Spanish Ministry of Economy and Competitiveness (MINECO) and the Pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (MINECO award SEV-2015–0505).es_ES
dc.subject.meshLactic Acid es_ES
dc.subject.meshPulmonary Embolism es_ES
dc.subject.meshHospitals es_ES
dc.subject.meshHumans es_ES
dc.subject.meshPrognosis es_ES
dc.subject.meshProspective Studies es_ES
dc.titleVenous lactate improves the prediction of in-hospital adverse outcomes in normotensive pulmonary embolism.es_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.contributor.funderMinisterio de Economía y Competitividad (España)
dc.contributor.funderFundación ProCNIC
dc.contributor.funderGerman Federal Ministry of Education and Research
dc.identifier.journalEuropean journal of internal medicinees_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Investigación Cardiovascular Traslacional Multidisciplinariaes_ES
dc.rights.accessRightsopen accesses_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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