Correlation between cortisol levels and myocardial infarction mortality among intensive coronary care unit patients during first seven days in hospital

Abstract

Aim: To measure cortisol level, its relationship with myocardial infarction, and to determine the correlation of elevated cortisol levels with the outcome of myocardial infarction.

Methods: This study was designed as a pre and post study. The diagnosis of myocardial infarction was established based on the WHO criteria. The patients were followed for seven days. Blood specimens were collected on day 1, 3, 5 and 7.

Results: Thirty six patients with myocardial infarction were studied. Four patients (11.1%) died and 32 patients (88.9%) survived. Nineteen patients (52.7%) had large infarcts and 23 patients (63.9%) had myocardial complications. The deceased patient's cortisol level differed significantly from those tht survived (65.68 + 29.07 vs 21350 + 15.82 microg/dl, p < 0.05). The groups with large infarcts and myocardial infarct complications had higher cortisol levels, but the difference was not significant compared with the group with small infarcts and patients without complications. Six patients (16.6%) who received thrombolytic therapy had significantly lower cortisol levels as compared to patients without thrombolytic therapy. The duration of elevation cortisol elevation in the deceased patient was longer than that among those who survived. Similar findings were also true for those with large infarcts when compared to those with small infarcts, as well as myocardial infarct patients with complications when compared to those without. However, the duration of cortisol elevation was shorter among patients who received thrombolytic therapy.

Conclusion: Cortisol level can be used as a prognostic marker for myocardial mortality.