From the Guidelines
In ST-elevation myocardial infarction (STEMI), glycogen levels decrease, ADP levels increase, and lactate levels rise due to the shift to anaerobic glycolysis, reflecting the energy crisis and contributing to contractile dysfunction and local acidosis. The provided evidence does not directly address the specific levels of glycogen, ADP, and lactate in patients with STEMI. However, based on the pathophysiology of STEMI, it is known that:
- Glycogen levels decrease as cardiomyocytes attempt to maintain energy production through anaerobic glycolysis when oxygen supply is compromised.
- ADP levels increase significantly during STEMI as ATP breakdown accelerates while its regeneration is impaired due to oxygen deficiency.
- Lactate levels increase substantially as anaerobic metabolism predominates, with lactate accumulation in the ischemic zone causing local acidosis that further impairs cardiac function. These metabolic changes are clinically relevant as they underlie the pathophysiology of myocardial damage and influence the timing of reperfusion therapy, which remains the cornerstone of STEMI management to salvage myocardium before irreversible damage occurs 1.
Some key points to consider in the management of STEMI include:
- The importance of early reperfusion therapy to salvage myocardium before irreversible damage occurs.
- The use of antiplatelet agents, anticoagulants, and beta-blockers to reduce morbidity and mortality.
- The management of hyperglycemia, with a goal of keeping blood glucose levels less than 180 mg/dL while avoiding hypoglycemia 1.
- The importance of lifestyle modifications, including smoking cessation, blood pressure control, and lipid management, to reduce the risk of future cardiovascular events 1.
Overall, while the specific levels of glycogen, ADP, and lactate in patients with STEMI are not directly addressed in the provided evidence, the pathophysiology of STEMI and the importance of early reperfusion therapy and evidence-based management strategies are well-established 1.
From the Research
Levels of Glycogen, ADP, and Lactate in STEMI Patients
- The levels of glycogen, ADP (adenosine diphosphate), and lactate in patients with ST-elevation myocardial infarction (MI) are not directly addressed in the provided studies 2, 3, 4, 5.
- However, one study 6 investigated the prognostic role of lactate in the acute phase of STEMI treated with mechanical revascularization.
- The study found that higher levels of lactate were associated with a progressive decline in estimated glomerular filtration rate and in ejection fraction, and that lactate levels were independent predictors for in-hospital mortality only in patients with advanced Killip class 6.
- Additionally, the study found that the increase in lactate values paralleled the progressive increase in glucose values, peak glycemia, troponin I, N-terminal pro-brain natriuretic peptide, and uric acid 6.
- There is no direct information available on the levels of glycogen and ADP in STEMI patients in the provided studies 2, 3, 4, 6, 5.