K.K. KHOLMATOVA, N.A. POLYARUSH, M.Yu. YURYEVA, S.N. IVANOVA, I.V. DVORYASHINA

Northern State Medical University, 51 Troitsky prospect, Arkhangelsk, Russian Federation, 163000

 Kholmatova K.K. — Ph. D. (medicine), Associate Professor of the Department of Hospital Therapy and Endocrinology, tel. (8182) 63-28-08, [email protected], ORCID ID: 0000-0002-5240-6470

Polyarush N.A. — Ph. D. (medicine), Associate Professor of the Department of Hospital Therapy and Endocrinology, tel.  (8182) 63-29-96, [email protected], ORCID: 0000-0001-9369-5857

Yuryeva M.Yu. — Assistant Lecture of the Department of Hospital Therapy and Endocrinology, tel. +7 (8182) 63-28-08, [email protected], ORCID ID 0000-0003-3864-383X

Ivanova S.N. — Ph. D. (medicine), Associate Professor of the Department of Hospital Therapy and Endocrinology, tel.  (8182) 63-29-96, [email protected], ORCID ID: 0000-0003-3959-6588

Dvoryashina I.V. — D. Sc. (medicine), Professor, Head of the Department of Hospital Therapy and Endocrinology, tel.  (8182) 63-29-96, [email protected], ORCID ID: 0000-0001-9230-0710

To assess plasma cortisol levels in patients with acute myocardial infarction (AMI) and glucose abnormalities (GA) during stabilized states and to study relationships between cortisol levels and long-term prognosis of AMI.

Material and methods. 360 subjects with AMI (63,6% men) aged 18–80 were examined. Plasma levels of insulin, C-peptide and cortisol during oral glucose tolerance test (OGTT) on the 10^th–14^th day after OIM, basal levels of apolipoproteins A1, B100, leptin and adiponectin fasting were defined in 113 consecutive patients. Group differences were analyzed by Kruskal-Wallis and χ2 tests. Long-term prognosis was assessed during two-year follow-up period. Logistic regression analysis was used to identify the risk factors of poor prognosis after AMI.

Results. All patients had increased basal level of cortisol (>600 nmol/l) and its decrease during OGGT despite the presence of GA. Patients with hypercortisolaemia had significantly higher levels of basal glycaemia (5,5 (5,05–5,78) vs 5,3 (5,10–5,83) mmol/l, p=0,006) and adipokines (leptin (131,9 (74,3–157,0) vs 127,0 (69,5–162,0) ng/ml, p<0,001) and adiponectin (3,83 (2,61–4,25) vs 3,82 (3,44–4,28) ug/ml, p=0,001). There were significant associations between basal hypercortisolaemia and long-term prognosis of AMI. It was an independent predictor of repeated AMI (OR=2,97, 95% CI=1,16–7,59, p=0,023) with adjustment for previous AMI on admission (p=0,038), glycaemia on admission (p=0,054), and any GA (p=0,475).

The conclusions. Basal cortisol levels were abnormally high in all patients with AMI regardless of the presence of GA. Basal hypercortisolaemia was associated with repeated AMI during two-year follow-up period.

Key words: cortisol, acute myocardial infarction, long-term prognosis.

(For citation: Kholmatova K.K., Polyarush N.A., Yuryeva M.Yu., Ivanova S.N., Ivanova S.N., Dvoryashina I.V. Association of cortisol with long-term prognosis in patients with acute myocardial infarction. Practical Medicine. 2018)

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