Document Detail

Low serum cortisol predicts early death after acute myocardial infarction.
MedLine Citation:
PMID:  20081532     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether low serum cortisol concentrations are associated with adverse prognosis in patients with acute myocardial infarction. Low serum cortisol concentrations have been associated with adverse prognosis in critical illness of diverse etiology. DESIGN: Nested case-control study. SETTING: Prospective cohort study of consecutive patients admitted with acute myocardial infarction to nine Scottish hospitals. PATIENTS: A total of 100 patients who survived 30 days (controls) and 100 patients who died within 30 days (cases). MEASUREMENTS AND MAIN RESULTS: Admission cortisol concentrations were lower in patients who died than those who survived (median, 1189 nmol/L vs. 1355 nmol/L; p < .001). A cortisol concentration in the bottom quartile (<1136 nmol/L) was a strong predictor of death within 30 days and remained so after adjustment for age and cardiac troponin concentration (adjusted odds ratio, 8.78; 95% confidence interval, 3.09-24.96; p < .001). CONCLUSIONS: Patients who mount a lesser cortisol stress response to acute myocardial infarction have a poorer early prognosis.
Rebecca M Reynolds; Brian R Walker; Sally Haw; David E Newby; Daniel F Mackay; Stuart M Cobbe; Alastair C H Pell; Colin Fischbacher; Stuart Pringle; David Murdoch; Frank Dunn; Keith Oldroyd; Paul Macintyre; Brian O'Rourke; Jill P Pell
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-19     Completed Date:  2010-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  973-5     Citation Subset:  AIM; IM    
Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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MeSH Terms
Aged, 80 and over
Case-Control Studies
Cohort Studies
Follow-Up Studies
Hospital Mortality
Hydrocortisone / blood*
Intensive Care Units
Middle Aged
Myocardial Infarction / blood*,  mortality*
Prospective Studies
Survival Analysis
Troponin / blood
Grant Support
//British Heart Foundation
Reg. No./Substance:
0/Troponin; 50-23-7/Hydrocortisone

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