Lactate as a predictor for determining invasive intervention time in non-ST-segment acute coronary syndromes

Objectives: The aim was to evaluate the correlation of lactate levels measured at admission with the urgency of intervention in patients diagnosed with non-ST-segment acute coronary syndromes (NST-ACS). Methods: This was a prospective observational study conducted in a research hospital between March 2020 and June 2021. Patients admitted to the emergency department with chest pain and diagnosed with NST-ACS were divided into four group according to the recommendations of the ESC 2015 guidelines to determine the priority of invasive intervention. Lactate levels were measured from venous blood samples. Whether there was a difference in terms of lactate levels between patients who were recommended for early invasive intervention (within 24 hours) and patients who were recommended for late invasive intervention (within 72 hours) was investigated. The sample size was estimated with G*Power and statistical analysis was performed using SPSS 22. Results: The mean age of the group recommended for early intervention was 62±11.45 years and the mean age of the group recommended for late intervention was 61±11.89 years. The time interval between the beginning of symptoms and admission to the emergency department was similar between the groups and the median was 4 hours. GRACE scores were significantly higher in the early intervention group. There was no difference in terms of lactate levels between the groups. Correlations between GRACE scores and lactate levels were statistically non-significant (p>0.05). Conclusion: Lactate alone was not a good predictor for risk analyses and determination of invasive intervention time in NST-ACS patients without urgent invasive intervention indications.