Sandeep K Jutla1, Matthew F Yuyun, Paulene A Quinn, Leong L Ng. 1. aDepartment of Cardiovascular Sciences, University of Leicester bNIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK *Sandeep K. Jutla and Matthew F. Yuyun contributed equally to the writing of the article.
Abstract
AIMS: Cortisol is associated with increased cardiovascular morbidity and mortality in patients with chronic heart failure and in the general population. The negative predictive effect of cortisol on survival in non-diabetic patients who have suffered an acute myocardial infarction (AMI) has been shown. We aimed to determine the prognostic significance of cortisol in a general group of AMI patients, as this is not well known. METHODS: Plasma cortisol levels were measured in 955 consecutive patients admitted with AMI. We prospectively evaluated the relationship between cortisol and major adverse cardiovascular event (MACE), which was a composite of all-cause mortality, and combination all-cause mortality and re-hospitalization for heart failure, in post-AMI patients. RESULTS: During the 2-year follow-up, MACE occurred in 261 patients (27.3%). Patients with MACE had significantly higher median levels of cortisol than those without (609.4 versus 549.4 pmol/ml, P = 0.0073). Log cortisol was independently predictive of MACE after adjusting for covariates with hazard ratio (95% confidence interval) of 1.55 (1.05-2.27), P = 0.027. Patients in the highest quartile of cortisol had significantly more risk of MACE compared with those in the lowest quartile, with an adjusted hazard ratio (95% confidence interval) of 1.91(1.16-3.15), P = 0.0120. Kaplan-Meier survival estimates for MACE were lower in patients with plasma cortisol levels in the highest quartile compared with those in the first three quartiles (Log rank test χ² for survival = 10.41, P = 0.0013). CONCLUSION: This study has shown the prognostic significance of cortisol in 955 post-AMI patients from a single centre.
AIMS: Cortisol is associated with increased cardiovascular morbidity and mortality in patients with chronic heart failure and in the general population. The negative predictive effect of cortisol on survival in non-diabeticpatients who have suffered an acute myocardial infarction (AMI) has been shown. We aimed to determine the prognostic significance of cortisol in a general group of AMI patients, as this is not well known. METHODS: Plasma cortisol levels were measured in 955 consecutive patients admitted with AMI. We prospectively evaluated the relationship between cortisol and major adverse cardiovascular event (MACE), which was a composite of all-cause mortality, and combination all-cause mortality and re-hospitalization for heart failure, in post-AMI patients. RESULTS: During the 2-year follow-up, MACE occurred in 261 patients (27.3%). Patients with MACE had significantly higher median levels of cortisol than those without (609.4 versus 549.4 pmol/ml, P = 0.0073). Log cortisol was independently predictive of MACE after adjusting for covariates with hazard ratio (95% confidence interval) of 1.55 (1.05-2.27), P = 0.027. Patients in the highest quartile of cortisol had significantly more risk of MACE compared with those in the lowest quartile, with an adjusted hazard ratio (95% confidence interval) of 1.91(1.16-3.15), P = 0.0120. Kaplan-Meier survival estimates for MACE were lower in patients with plasma cortisol levels in the highest quartile compared with those in the first three quartiles (Log rank test χ² for survival = 10.41, P = 0.0013). CONCLUSION: This study has shown the prognostic significance of cortisol in 955 post-AMI patients from a single centre.
Authors: Nor Amira Syahira Mohd Azmi; Norsham Juliana; Sahar Azmani; Nadia Mohd Effendy; Izuddin Fahmy Abu; Nur Islami Mohd Fahmi Teng; Srijit Das Journal: Int J Environ Res Public Health Date: 2021-01-14 Impact factor: 3.390
Authors: Stefan Pilz; Verena Theiler-Schwetz; Christian Trummer; Martin H Keppel; Martin R Grübler; Nicolas Verheyen; Balazs Odler; Andreas Meinitzer; Jakob Voelkl; Winfried März Journal: J Endocr Soc Date: 2021-02-10
Authors: Andrei V Tarasov; Rofail S Rakhmanov; Elena S Bogomolova; Ludmila A Perminova; Zhanna L Malakhova Journal: Nutrients Date: 2021-06-20 Impact factor: 5.717
Authors: M von Wolff; C T Nakas; M Tobler; T M Merz; M P Hilty; J D Veldhuis; A R Huber; J Pichler Hefti Journal: Endocr Connect Date: 2018-10-01 Impact factor: 3.335