Prognostic Value of Cortisol Index of Endobiogeny in Acute Myocardial Infarction Patients

Abstract

Background and Objectives: Serum cortisol has been extensively studied for its role during acute myocardial infarction (AMI). Reports have been inconsistent, with high and low serum cortisol associated with various clinical outcomes. Several publications claim to have developed methods to evaluate cortisol activity by using elements of complete blood count with its differential. This study aims to compare the prognostic value of the cortisol index of Endobiogeny with serum cortisol in AMI patients, and to identify if the risk of mortality in AMI patients can be more precisely assessed by using both troponin I and cortisol index than troponin I alone. Materials and methods: This prospective study included 123 consecutive patients diagnosed with AMI. Diagnostic coronary angiography and revascularization was performed for all patients. Cortisol index was measured on admission, on discharge, and after 6 months. Two year follow-up for all patients was obtained. Results: Our study shows cortisol index peaks at 7–12 h after the onset of AMI, while serum cortisol peaked within 3 h from the onset of AMI. The cortisol index is elevated at admission, then significantly decreases at discharge; furthermore, the decline to its bottom most at 6 months is observed with mean values being constantly elevated. The cortisol index on admission correlated with 24-month mortality. We established combined cut-off values of cortisol index on admission > 100 and troponin I > 1.56 μg/las a prognosticator of poor outcomes for the 24-month period. Conclusions: The cortisol index derived from the global living systems theory of Endobiogeny is more predictive of mortality than serum cortisol. Moreover, a combined assessment of cortisol index and Troponin I during AMI offers more accurate risk stratification of mortality risk than troponin alone.

Evolution of Modeled Cortisol Is Prognostic of Death in Hospitalized Patients With COVID-19 Syndrome

“…The latter two are rapid, cost effective, and easily repeated throughout hospitalization. We (KMH, JCL) have demonstrated the value of this approach to modeling in predicting mortality on admission for patients admitted with acute myocardial infarction ( 17 ).…”

“…Tissue levels have not consistently been associated with severity of illness ( 13 , 14 ). Our group (KMH, JCL) has demonstrated that the effective tissue-level activity of cortisol can be modeled using a complete blood count with differential (CBC) ( 15 ) in chronic heart failure and acute myocardial infarction (AMI) ( 16 , 17 ) and that the model of admission cortisol activity was superior to serum cortisol in predicting mortality in AMI ( 17 ). The formation of the index is based on the observation that cortisol increases erythrocytes, leukocytes, neutrophils, and monocytes, and, it diminish lymphocytes, eosinophils, and the eosinophil/monocyte ratio ( 18 – 21 ).…”

Endobiogenic Biology of Function Indices in a Cohort of Kidney Transplant Recipients

“…In the existing literature, certain BoF indices have been analyzed in patients with myocardial infarction, COVID-19 infection, or heart failure [ 28 , 29 , 30 ]; however, we could not find any data about BoF indices in a kidney transplant recipient population. Therefore, the aim of this study was to calculate some of the BoF indices in kidney transplant recipients, enabling the analysis of the relationship between the BoF indices and biopsy-proven transplant rejection.…”