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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Pilz, S; Theiler-Schwetz, V; Trummer, C; Keppel, MH; Grübler, MR; Verheyen, N; Odler, B; Meinitzer, A; Voelkl, J; März, W.
Associations of Serum Cortisol with Cardiovascular Risk and Mortality in Patients Referred to Coronary Angiography.
J Endocr Soc. 2021; 5(5):bvab017 Doi: 10.1210/jendso/bvab017 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Pilz Stefan
Theiler-Schwetz Verena
Co-Autor*innen der Med Uni Graz
Grübler Martin
Keppel Martin
März Winfried
Meinitzer Andreas
Odler Balazs
Trummer Christian
Verheyen Nicolas Dominik

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CONTEXT: Serum cortisol may be associated with cardiovascular risk factors and mortality in patients undergoing coronary angiography, but previous data on this topic are limited and controversial. OBJECTIVE: We evaluated whether morning serum cortisol is associated with cardiovascular risk factors, lymphocyte subtypes, and mortality. METHODS: This is a prospective cohort study performed at a tertiary care centre in south-west Germany between 1997 and 2000. We included 3052 study participants who underwent coronary angiography. The primary outcome measures were cardiovascular risk factors, lymphocyte subtypes, and all-cause and cardiovascular mortality. RESULTS: Serum cortisol was associated with an adverse cardiovascular risk profile, but there was no significant association with coronary artery disease or acute coronary syndrome. In a subsample of 2107 participants, serum cortisol was positively associated with certain lymphocyte subsets, including CD16+CD56+ (natural killer) cells (P < 0.001). Comparing the fourth versus the first serum cortisol quartile, the crude Cox proportional hazard ratios (with 95% CIs) were 1.22 (1.00-1.47) for all-cause and 1.32 (1.04-1.67) for cardiovascular mortality, respectively. After adjustments for various cardiovascular risk factors, these associations were attenuated to 0.93 (0.76-1.14) for all-cause, and 0.97 (0.76-1.25) for cardiovascular mortality, respectively. CONCLUSIONS: Despite significant associations with classic cardiovascular risk factors and natural killer cells, serum cortisol was not a significant and independent predictor of mortality in patients referred to coronary angiography. These findings might reflect that adverse cardiovascular effects of cortisol could be counterbalanced by some cardiovascular protective actions.

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