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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Low serum cortisol predicts early death after acute myocardial infarction
Author(s): Reynolds, Rebecca M
Walker, Brian R
Haw, Sally
Newby, David E
Mackay, Daniel F
Cobbe, Stuart M
Pell, Alastair C H
Fischbacher, Colin
Pringle, Stuart D
Murdoch, David
Dunn, Frank
Oldroyd, Keith G
MacIntyre, Paul D
O'Rourke, Brian
Pell, Jill
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Keywords: acute myocardial infarction
adrenal insufficiency
nested case-control study
Issue Date: Mar-2010
Date Deposited: 17-Sep-2013
Citation: Reynolds RM, Walker BR, Haw S, Newby DE, Mackay DF, Cobbe SM, Pell ACH, Fischbacher C, Pringle SD, Murdoch D, Dunn F, Oldroyd KG, MacIntyre PD, O'Rourke B & Pell J (2010) Low serum cortisol predicts early death after acute myocardial infarction. Critical Care Medicine, 38 (3), pp. 973-975.
Abstract: Objective: To determine whether low serum cortisol concentrations are associated with adverse prognosis in patients with acute myocardial infarction. Low serum cortisol concentrations have been associated with adverse prognosis in critical illness of diverse etiology. Design: Nested case-control study. Setting: Prospective cohort study of consecutive patients admitted with acute myocardial infarction to nine Scottish hospitals. Patients: A total of 100 patients who survived 30 days (controls) and 100 patients who died within 30 days (cases). Measurements and Main Results: Admission cortisol concentrations were lower in patients who died than those who survived (median, 1189 nmol/L vs. 1355 nmol/L; p < .001). A cortisol concentration in the bottom quartile (<1136 nmol/L) was a strong predictor of death within 30 days and remained so after adjustment for age and cardiac troponin concentration (adjusted odds ratio, 8.78; 95% confidence interval, 3.09-24.96; p < .001). Conclusions: Patients who mount a lesser cortisol stress response to acute myocardial infarction have a poorer early prognosis.
DOI Link: 10.1097/CCM.0b013e3181cdf6de
Rights: Publisher policy allows this work to be made available in this repository. This is a non-final version of an article published in final form in Critical Care Medicine: March 2010 - Volume 38 - Issue 3 - pp 973-975, doi: 10.1097/CCM.0b013e3181cdf6de by the Society of Critical Care Medicine and Lippincott Williams & Wilkins. The original publication is available at:

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