PMID- 32235490
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240328
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 9
IP  - 4
DP  - 2020 Mar 30
TI  - Elevated Lactate Levels in Acute Pulmonary Embolism Are Associated with 
      Prothrombotic Fibrin Clot Properties: Contribution of NETs Formation.
LID - 10.3390/jcm9040953 [doi]
LID - 953
AB  - BACKGROUND: Elevated plasma lactate levels correlate with high mortality rate in 
      acute pulmonary embolism (PE) patients. We hypothesized that elevated lactate 
      levels correlate with prothrombotic fibrin clot properties and enhanced 
      neutrophil extracellular trap (NET) formation in acute PE. METHODS: As many as 
      126 normotensive acute PE patients (aged 58 +/- 14 years) were enrolled. Plasma 
      fibrin clot permeability (K(s)), clot lysis time (CLT), endogenous thrombin 
      potential (ETP), citrullinated histone H3 (citH3), and plasminogen activator 
      inhibitor-1 antigen (PAI-1), together with plasma L-lactate levels were evaluated 
      on admission. RESULTS: Lactate levels >/=2 mM were found in 70 (55.6%) patients in 
      whom we observed 29% higher neutrophil count and 45% elevated plasma citH3 
      levels. Elevated lactate levels were associated with more prothrombotic fibrin 
      properties as reflected by 11% reduced K(s), 13% longer CLT, along with 11% 
      increased ETP. Lactate levels were positively associated with plasma citH3 
      concentrations, ETP, CLT, and PAI-1 (p < 0.05). An increase of lactate levels by 
      1 mM leading to the prolongation of CLT by 8.82 minutes was shown in the linear 
      regression. CONCLUSIONS: Our findings suggest a new mechanism contributing to a 
      negative impact of elevated lactate levels on prognosis in acute PE patients, in 
      particular hypofibrinolysis, associated with enhanced NET formation.
FAU - Zabczyk, Michal
AU  - Zabczyk M
AD  - Institute of Cardiology, Jagiellonian University Medical College, 31-202 Krakow, 
      Poland.
AD  - John Paul II Hospital, 31-202 Krakow, Poland.
FAU - Natorska, Joanna
AU  - Natorska J
AD  - Institute of Cardiology, Jagiellonian University Medical College, 31-202 Krakow, 
      Poland.
AD  - John Paul II Hospital, 31-202 Krakow, Poland.
FAU - Janion-Sadowska, Agnieszka
AU  - Janion-Sadowska A
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      25-317 Kielce, Poland.
FAU - Malinowski, Krzysztof P
AU  - Malinowski KP
AD  - Institute of Public Health, Faculty of Health Sciences, Jagiellonian University 
      Medical College, 31-126 Krakow, Poland.
FAU - Janion, Marianna
AU  - Janion M
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      25-317 Kielce, Poland.
FAU - Undas, Anetta
AU  - Undas A
AD  - Institute of Cardiology, Jagiellonian University Medical College, 31-202 Krakow, 
      Poland.
AD  - John Paul II Hospital, 31-202 Krakow, Poland.
AD  - The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, 
      25-317 Kielce, Poland.
LA  - eng
GR  - UMO-2015/B/NZ5/02215/Narodowe Centrum Nauki/
PT  - Journal Article
DEP - 20200330
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC7231195
OTO - NOTNLM
OT  - NETosis
OT  - acute thrombosis
OT  - fibrinolysis
OT  - lactate
OT  - pulmonary embolism
COIS- The authors declare no conflict of interest.
EDAT- 2020/04/03 06:00
MHDA- 2020/04/03 06:01
PMCR- 2020/03/30
CRDT- 2020/04/03 06:00
PHST- 2020/02/28 00:00 [received]
PHST- 2020/03/24 00:00 [revised]
PHST- 2020/03/27 00:00 [accepted]
PHST- 2020/04/03 06:00 [entrez]
PHST- 2020/04/03 06:00 [pubmed]
PHST- 2020/04/03 06:01 [medline]
PHST- 2020/03/30 00:00 [pmc-release]
AID - jcm9040953 [pii]
AID - jcm-09-00953 [pii]
AID - 10.3390/jcm9040953 [doi]
PST - epublish
SO  - J Clin Med. 2020 Mar 30;9(4):953. doi: 10.3390/jcm9040953.