{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T03:52:39Z","timestamp":1792900359544,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lactic acidosis is associated with mortality in patients with cardiogenic shock (CS). Elevated lactate levels and systemic acidemia (low blood pH) have both been proposed as drivers of death. We, therefore, analyzed the association of both high lactate concentrations and low blood pH with 30\u2010day mortality in patients with CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">This was a 2\u2010center historical cohort study of unselected patients with CS with available data for admission lactate level or blood pH. CS severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock classification. All\u2010cause survival at 30\u00a0days was analyzed using Kaplan\u2010Meier curves and Cox proportional\u2010hazards analysis. There were 1814 patients with CS (mean age, 67.3\u00a0years; 68.5% men); 51.8% had myocardial infarction and 53.0% had cardiac arrest. The distribution of SCAI shock stages was B, 10.8%; C, 30.7%; D, 38.1%; and E, 18.7%. In both cohorts, higher lactate or lower pH predicted a higher risk of adjusted 30\u2010day mortality. Patients with a lactate \u22655\u00a0mmol\/L or pH &lt;7.2 were at increased risk of adjusted 30\u2010day mortality; patients with both lactate \u22655\u00a0mmol\/L and pH &lt;7.2 had the highest risk of adjusted 30\u2010day mortality. Patients in SCAI shock stages C, D, and E had higher 30\u2010day mortality in each SCAI shock stage if they had lactate \u22655\u00a0mmol\/L or pH &lt;7.2, particularly if they met both criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher lactate and lower pH predict mortality in patients with cardiogenic shock beyond standard measures of shock severity. Severe lactic acidosis may serve as a risk modifier for the SCAI shock classification. Definitions of refractory or hemometabolic shock should include high lactate levels and low blood pH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.024932","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T05:51:35Z","timestamp":1651470695000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Association Between the Acidemia, Lactic Acidosis, and Shock Severity With Outcomes in Patients With Cardiogenic Shock"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-2859","authenticated-orcid":false,"given":"Jacob C.","family":"Jentzer","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"},{"name":"Division of Pulmonary and Critical Care Medicine Department of Medicine Mayo Clinic Rochester 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