title: Correlation between cortisol levels and myocardial infarction mortality among intensive coronary care unit patients during first seven days in hospital.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Cortisol level can be used as a prognostic marker for myocardial mortality.
authors.affiliation: Division of Renal-Hypertension, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta.
authors.forename: Imran
authors.initials: I
authors.lastname: Nito
authors.forename: Sarwono
authors.initials: S
authors.lastname: Waspadji
authors.forename: S
authors.initials: S
authors.lastname: Harun
authors.forename: H M S
authors.initials: HM
authors.lastname: Markum
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003325:Coronary Care Units; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone