Esra POLAT, Şükrü ÇİRİŞ
Interventional Cardiology Perspectives - 2026;2(2):59-66
Background: Serum lactate is an easily measurable marker that reflects tissue hypoperfusion and systemic stress. Although numerous studies have investigated this topic, no lactate cut-off value associated with mortality has been established for elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI). Aim: This study aimed to determine the relationship between lactate levels and 1-month mortality and complications in elderly patients with NSTEMI. Study Design: Retrospective cohort study. Methods: This study included 110 patients aged >=65 years who were diagnosed with NSTEMI between August 2024 and August 2025. Baseline lactate levels, duration of hospital stay, 1-month mortality, arrhythmia, cerebrovascular events, recurrent myocardial infarction (MI), contrast-induced nephropathy, deep vein thrombosis/pulmonary embolism, and bleeding events were evaluated. Results: The mean age was 78.61 +/-8.27 years, and the mean ejection fraction was 46.68 +/-11.52%. The 1-month mortality rate was 16.4%. Admission lactate demonstrated good discriminatory ability for predicting mortality [area under the curve=0.785; 95% confidence interval (CI): 0.651-0.919; p<0.001]. A cut-off value of >=2.25 mmol/L yielded a sensitivity of 72.2% and a specificity of 72.8%. Patients with lactate levels >=2.25 mmol/L had significantly higher mortality than those with lower levels (34.2% vs. 6.9%, p<0.001). In the multivariable logistic regression analysis, only lactate levels [odds ratio (OR)=1.35; 95% CI: 1.04-1.76; p=0.023] and fasting glucose levels (OR=1.01; p=0.010) were identified as independent predictors of mortality. Conclusion: Higher lactate levels were associated with short-term mortality in elderly patients with NSTEMI. Because of its rapid availability and low cost, lactate may serve as a practical and useful marker for early risk assessment in this population.
