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Review
. 2018 Aug;13(1):29-34.
doi: 10.15420/ecr.2017:19:3.

Neuroendocrine System Regulatory Mechanisms: Acute Coronary Syndrome and Stress Hyperglycaemia

Ricardo A Perez de la Hoz  1 , Sandra Patricia Swieszkowski  1 , Federico Matias Cintora  1 , Jose Martin Aladio  1 , Claudia Mariana Papini  1 , Maia Matsudo  1 , Alejandra Silvia Scazziota  1
Affiliations
Review

Neuroendocrine System Regulatory Mechanisms: Acute Coronary Syndrome and Stress Hyperglycaemia

Ricardo A Perez de la Hoz et al. Eur Cardiol. 2018 Aug.

Abstract

Neurohormonal systems are activated in the early phase of acute coronary syndromes to preserve circulatory homeostasis, but prolonged action of these stress hormones might be deleterious. Cortisol reaches its peak at 8 hours after the onset of symptoms, and individuals who have continued elevated levels present a worse prognosis. Catecholamines reach 100-1,000-fold their normal plasma concentration within 30 minutes of ischaemia, therefore inducing the propagation of myocardial damage. Stress hyperglycaemia induces inflammation and endothelial dysfunction, and also has procoagulant and prothrombotic effects. Patients with hyperglycaemia and no diabetes elevated in-hospital and 12-month mortality rates. Hyperglycaemia in patients without diabetes has been shown to be an appropriate independent mortality prognostic factor in this type of patient.

Keywords: Acute coronary syndrome; catecholamines; coronary thrombosis; cortisol; hyperglycaemia; insulin; neurosecretory systems; prognosis.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

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