The Use of Cortisol as an Early Marker for Acute Myocardial Infarction in an Emergency Department Setting

[~MaryO~]

http://www.aemj.org/cgi/content/full/14/5_Supplement_1/S125

 

Acad Emerg Med Volume 14, 5 Supplement 1 125,

? 2007 Society for Academic Emergency Medicine

 

The Use of Cortisol as an Early Marker for Acute Myocardial Infarction in an Emergency Department Setting

John Gough, Velvet Patterson and Kori Brewer

 

Brody School of Medicine

 

Background

 

Acute myocardial infarction is traditionally confirmed or ruled out using EKG and cardiac enzymes. However, these tests may be nonspecific and time dependent, delaying intervention. It is important to continue to find new markers that can help expedite the evaluation and treatment of MI patients. The current study examines the utility of the stress hormone cortisol as an initial marker of infarction in patients presenting to the ED with acute chest pain.

 

Objectives

 

To determine if serum cortisol levels are significantly altered in patients presenting with acute chest pain of cardiac etiology.

 

Methods

 

A convenience sample of patients presenting with a chief complaint of chest pain were enrolled. All patients had blood drawn for cortisol levels in addition to standard cardiac enzymes. Patient charts were reviewed after ED or hospital discharge to obtain data on EKG changes, initial and maximum troponin levels and final diagnosis.

 

Results

 

113 patients were enrolled. 35 had elevated serum cortisol levels (>18 ug/dl) with levels being higher in those patients with chest pain of cardiac etiology than in non-cardiac cases (17.1 ? 1.9 vs. 12.3 ? 1.0; p

 

Conclusions

 

Cortisol levels were found to be high in patients with cardiac chest pain, and significantly elevated in patients diagnosed with MI. This suggests that cortisol may be a valuable predictor of cardiac disease and could potentially serve as a cardiac marker for MI in the emergency setting.