1. Prognostic Value of Cortisol Index of Endobiogeny in Acute Myocardial Infarction Patients
- Author
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Astra Vitkauskiene, Vaiva Lesauskaite, Jean Claude Lapraz, Ali Aldujeli, Kamyar M. Hedayat, Rima Braukyliene, Brigita Hedayat, Ramunas Unikas, Diana Zaliaduonyte, Martynas Jurenas, Vytautas Zabiela, Sandrita Simonyte, Osvaldas Petrokas, Rasa Steponaviciute, and Laura Zajanckauskiene
- Subjects
medicine.medical_specialty ,endocrine system ,Medicine (General) ,Hydrocortisone ,medicine.medical_treatment ,Myocardial Infarction ,acute myocardial infarction ,030204 cardiovascular system & hematology ,Revascularization ,Article ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,Internal medicine ,Troponin I ,Risk of mortality ,medicine ,Humans ,cardiovascular diseases ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Prospective cohort study ,medicine.diagnostic_test ,biology ,business.industry ,Complete blood count ,General Medicine ,cortisol index ,Prognosis ,medicine.disease ,Troponin ,Cardiology ,biology.protein ,serum cortisol ,business ,Biomarkers ,Serum cortisol ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background and Objectives: Serum cortisol has been extensively studied for its role during acute myocardial infarction (AMI). Reports have been inconsistent, with high and low serum cortisol associated with various clinical outcomes. Several publications claim to have developed methods to evaluate cortisol activity by using elements of complete blood count with its differential. This study aims to compare the prognostic value of the cortisol index of Endobiogeny with serum cortisol in AMI patients, and to identify if the risk of mortality in AMI patients can be more precisely assessed by using both troponin I and cortisol index than troponin I alone. Materials and methods: This prospective study included 123 consecutive patients diagnosed with AMI. Diagnostic coronary angiography and revascularization was performed for all patients. Cortisol index was measured on admission, on discharge, and after 6 months. Two year follow-up for all patients was obtained. Results: Our study shows cortisol index peaks at 7–12 h after the onset of AMI, while serum cortisol peaked within 3 h from the onset of AMI. The cortisol index is elevated at admission, then significantly decreases at discharge, furthermore, the decline to its bottom most at 6 months is observed with mean values being constantly elevated. The cortisol index on admission correlated with 24-month mortality. We established combined cut-off values of cortisol index on admission >, 100 and troponin I >, 1.56 μg/las a prognosticator of poor outcomes for the 24-month period. Conclusions: The cortisol index derived from the global living systems theory of Endobiogeny is more predictive of mortality than serum cortisol. Moreover, a combined assessment of cortisol index and Troponin I during AMI offers more accurate risk stratification of mortality risk than troponin alone.
- Published
- 2021