Low serum cortisol predicts early death following acute myocardial infarction

Reynolds, R.M. et al. (2010) Low serum cortisol predicts early death following acute myocardial infarction. Critical Care Medicine, 38(3), pp. 973-975. (doi: 10.1097/CCM.0b013e3181cdf6de)

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<b>Objective</b>: Low serum cortisol concentrations have been associated with adverse prognosis in critical illness of diverse aetiology. We aimed to determine whether low serum cortisol concentrations are associated with adverse prognosis in patients with acute myocardial infarction. <b>Design</b>: Nested case-control study. <b>Setting</b>: Prospective cohort study of consecutive patients admitted with acute myocardial infarction to 9 Scottish hospitals. <b>Patients</b>: 100 patients who survived 30 days (controls) and 100 patients who died within 30 days (cases). <b>Measurements and Main Results</b>: Admission cortisol concentrations were lower in patients who died than those who survived (median 1,189 versus 1,355 nmol/L, p<0.001). A cortisol concentration in the bottom quartile (<1,136 nmol/L) was a strong predictor of death within 30 days, and remained so after adjustment for age and cardiac troponin concentration (adjusted OR 8.78, 95% CI 3.09-24.96, p<0.001). <b>Conclusions</b>: Patients who mount a lesser cortisol stress response to acute myocardial infarction have a poorer early prognosis.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Oldroyd, Dr Keith and MacIntyre, Dr Paul and Pell, Professor Jill and Cobbe, Professor Stuart and Mackay, Professor Daniel
Authors: Reynolds, R.M., Walker, B.R., Haw, S., Newby, D.E., Mackay, D.F., Cobbe, S.M., Pell, A.C.H., Fischbacher, C.M., Pringle, S., Murdoch, D., Dunn, F., Oldroyd, K., MacIntyre, P., O’Rourke, B., and Pell, J.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences
Journal Name:Critical Care Medicine
Publisher:Lippincott, Williams and Wilkins
ISSN (Online):1530-0293
Published Online:14 January 2010
Copyright Holders:Copyright © 2010 Lippincott, Williams and Wilkins
First Published:First published in Critical Care Medicine 38(3)
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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