Hair cortisol as chronic stress parameter in patients with acute ST-segment elevation myocardial infarction

Abstract

Stress is arisk factor for the development of cardiovascular diseases. New analytical methods enable the determination of cortisol concentrations in hair (HCC) as aretrospective long-term parameter for chronic stress. So far, it is still uncertain whether stress objectively measured by an increase in HCC might be apredictive factor associated with the development of an acute myocardial infarction. Included in this study were 40patients with an acute ST-segment elevation myocardial infarction (STEMI), confirmed by electrocardiography (ECG). The control group consisted of 80 patients without coronary artery disease (CAD). Patients with STEMI did not show significantly higher HCCs (p = 0.846) compared to the control group and there was no correlation with the extent of myocardial infarction (p = 0.701, r = 0.038). Correlations were found between HCC, diabetes mellitus (p = 0.046, odds ratio, OR = 6.346), low high-density lipoprotein (HDL) cholesterol concentration (p = 0.107) and glycated hemoglobin A (HbA1c) concentration (p = 0.083, r = 0.236). Furthermore, there was an association between an increased HCC and chronic heart failure (p = 0.110) and an association to the red blood cell distribution width (RDW) concentration (p = 0.005, r = 0.293). The results of this study showed that patients with acute ST-segment elevation myocardial infarction did not have significantly higher levels of hair cortisol compared to the reference group; however, long-term metabolic changes as well as advanced chronic heart failure appear to be long-acting stress factors for the organism and increase cortisol levels in hair.