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The Prognostic Role of Cortisol and Glucose Dynamics in Cardiogenic Shock-Insights from a Prospective Observational

Priyanka Boettger1, Laura Pallmann2, Jamschid Sedighi3

  • 1Department of Internal Medicine I, Cardiology, Angiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 33, 35392, Giessen, Hessen, Germany. Priyanka.boettger@uni-giessen.de.

Journal of Cardiovascular Translational Research
|October 18, 2025
PubMed

Insights

High glucose and cortisol levels after heart attack-related cardiogenic shock (CS) predict mortality. Early normalization of glucose improves survival, highlighting metabolic markers as key targets for intervention.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Medicine

Background:

  • Cardiogenic shock (CS) following myocardial infarction has a high mortality rate.
  • The prognostic significance of dynamic metabolic markers, specifically glucose and cortisol, in CS is not fully understood.

Purpose of the Study:

  • To investigate the prognostic value of serial glucose and cortisol measurements in patients with myocardial infarction-related CS.
  • To identify metabolic markers that predict in-hospital mortality in this patient population.

Main Methods:

  • Prospective cohort study of 41 patients with infarction-related CS.
  • Serial blood sampling over 96 hours to measure plasma glucose and serum cortisol levels.
  • Primary endpoint: in-hospital mortality.

Main Results:

  • Admission glucose levels showed a trend towards increased mortality (36.4% for <10 mmol/L, 43.8% for 10-15 mmol/L, 50.0% for >15 mmol/L).
  • Early glucose normalization (≤6 hours) was associated with improved survival (25% vs. 45%).
  • Survivors had a rapid decline in cortisol levels, while non-survivors had persistently high levels (p=0.016 for AUC₀-₉₆).

Conclusions:

  • Early and sustained hyperglycemia and hypercortisolemia are independent predictors of mortality in infarction-related CS.
  • These metabolic derangements represent potential targets for therapeutic intervention to improve outcomes.

Keywords:
Acute myocardial infarctionBiomarkersCardiogenic shockCortisolCritical careEndocrine profilingGlucosePredictorsStress responseSurvivorsTranslational research

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