To assess the prognostic value of systemic arterial lactate levels in patients with ST segment elevation myocardial infarction undergoing primary PCI and correlate with the results of primary PCI and 30 days MACE follow up.

• Study Population: STEMI patients treated with primary PCI.
• Study period: over 6 months.
• Sample Size: 300 patients.

All patients received the standard care for acute STEMI patients which is the primary percutaneous intervention in addition to medications.

Hyperlactemia is defined as elevated lactic acid level in the blood. The normal blood lactate level is (0.5-1 mmol/L).

All subjects were subjected to

1. Careful history taking

2. Full cardiac examination

3. Investigations include:

   1. 12 lead surface ECG.
   2. Lactate level and full labs
   3. Pre-discharge echocardiography
   4. Peri-procedural details of primary PCI

the investigators assessed the relation between hyperlactemia and coronary flow, peak cardiac enzymes, hemodynamic parameters and MACE in 30 days follow up

Inclusion Criteria:

• Patient with ST-segment elevation myocardial infarction for the first time.
• Patients undergoing primary PCI.
• Adult patients ≥ 18 years old.

Exclusion criteria:

• Hemodynamically unstable patients.
• Patients with renal impairment (creatinine clearance < 30 ml/min).
• Patients who developed flow limiting coronary dissection or mechanical complication during the procedure.
• Patients presenting > 24 hours after symptoms onset.

STEMI patients treated with primary PCI