Serum cortisol levels predict infarct size and patient mortality

Area of Science:

• Endocrinology
• Cardiology
• Biochemistry

Background:

• Acute myocardial infarction (AMI) is a leading cause of mortality worldwide.
• Early diagnosis and prognostic assessment are crucial for effective patient management.
• The role of stress hormones like cortisol in AMI pathophysiology requires further elucidation.

Purpose of the Study:

• To prospectively investigate the serum cortisol response in patients with acute myocardial infarction.
• To determine the relationship between cortisol levels and infarct size.
• To assess the predictive value of cortisol levels for mortality in AMI patients.

Main Methods:

• Prospective study of 70 consecutive patients admitted to a coronary care unit with AMI.
• Measurement of serum cortisol levels early in the course of illness.
• Quantification of infarct size using creatine kinase MB (CK-MB) release.
• Correlation analysis between cortisol levels, infarct size, and mortality.

Main Results:

• Serum cortisol levels were significantly elevated early in AMI, preceding CK-MB elevation.
• The magnitude of cortisol response correlated with infarct size (rs = 0.54, P < 0.001).
• Very high serum cortisol levels (> 2000 mumol/l) were predictive of mortality (P < 0.05).

Conclusions:

• Serum cortisol levels may serve as an early indicator of acute myocardial infarction.
• Elevated cortisol levels are associated with larger infarct size and increased mortality risk.
• Cortisol response assessment could aid in identifying high-risk AMI patients.