ECE2011 Poster Presentations Cardiovascular endocrinology and lipid metabolism (34 abstracts)
Cortisol secretion and HPA axis activity in patients undergoing coronary angiography
T Isailovic , M Petakov , D J Macut , J Antic , S Ognjanovic , B Popovic , I Bozic , V Elezovic , Tamara Bogavac & Svetozar Damjanovic
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia.
Introduction: Several studies have shown that cortisol and altered HPA axis activity may participate in pathogenesis and severity of coronary artery disease (CAD).
Aim: To examine possible interaction between cortisol secretion and HPA axis activity with severity of CAD.
Patients and methods: Diurnal cortisol secretion and dexamethasone suppression test (DST) were analyzed in 200 consecutive patients (mean age 59.3±8.6) referred for coronary angiography due to suspected CAD. Basal cortisol secretion was measured as well in 60 age, sex, and BMI-matched healthy control subjects (CS). Patients were divided in two groups according to positive (PA) and negative (NA) coronary angiogram. Severity of and the extent of disease was assessed by Gensini and disease extent scores.
Results: There was no difference in the basal cortisol concentration between NA and PA patients (474.9±153.8 vs 449.2±155.6, P>0.05), however both NA and PA patients had significantly higher basal cortisol in comparison to CS (394.9±127.6, P<0.05, for both). No difference in diurnal cortisol rhythm and the ability to suppress cortisol after 1 mg of dexamethasone was found between NA and PA patients. A weak and negative correlation between basal cortisol and severity of CAD was obtained only in male patients by both Gensini (r=0.16, two-tailed P=0.01) and extent of disease score (r=0.17, two-tailed P=0.02). After adjustment for potential confounding factors, cortisol during DST proved to be an independent predictor of severity of CAD obtained by the extent score (B=2.6, P=0.019, R2=0.15, adj. P=0.13).
Conclusion: Patients undergoing coronary angiography have higher basal cortisol level than healthy subjects. There is no difference in diurnal cortisol secretion or HPA sensitivity between patients with positive and negative angiogram. HPA axis suppression ability is an independent predictor of severity of CAD obtained by the extent score of disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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