Serum Lactic Acid Levels, Lactate Clearance, and Uric Acid Levels as Prognostic Markers in Acute Coronary Syndrome Patients

Introduction: India represents the highest burden of acute coronary syndrome (ACS) in the world. There is a rising trend in the development of coronary heart disease in the rural as well as urban India and two-fold increases in mortality from 1985 to present. We need to bridge the gap between available diagnostic facilities and treatment modalities among health-care practitioners. Aim: The aim of this work was to assess the prognostic role of serum lactic acid, lactate clearance, and serum uric acid in ACS patients. Materials and Methods: It is a prospective observational study. 50 patients admitted to our hospital intensive care unit with a diagnosis of ACS were included in our study. Sample Collection: About 3 ml of venous blood is collected on admission and 48 h after admission. Serum lactic acid levels were estimated on admission and 48 h after in 50 patients and uric acid levels were tested on admission. The outcome of the patients, death or survival of the patient is recorded. Age, gender, body mass index, vital parameters, supportive measures given, electrocardiogram and Echo findings, blood urea and creatinine values, duration of hospital stay of the patient, and time of death since admission were noted. We also have compared the lactic acid levels, lactate clearance and uric acid levels with GRACE scoring system and Killip class. Results: In our study, average uric acid levels were higher among survivors compared to nonsurvivors (P = 0.0019). Serum uric acid levels were higher among patients with higher Killip class. Conclusion: There is no significant difference in lactic acid levels between survivors and nonsurvivors (P = 0.83). Lactic acid is positively correlated with GRACE score. Lactate clearance is negatively correlated with GRACE score.