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Haarkortisol als chronischer Stressparameter bei Patienten mit akutem ST-Strecken-Hebungs-Infarkt

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

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Zusammenfassung

Einleitung

Stress gilt als Risikofaktor für die Entstehung kardiovaskulärer Erkrankungen. Neue Analyseverfahren erlauben die Bestimmung des Kortisols im Haar (HCC) als retrospektivem Langzeitparameter für chronischen Stress. Es ist unklar, ob Stress, objektiv gemessen anhand einer erhöhten HCC, mit der Entstehung eines akuten Myokardinfarkts assoziiert ist.

Methoden

In diese Studie wurden 40 Patienten mit der Diagnose eines akuten ST-Strecken-Hebungs-Infarkts (STEMI) im Elektrokardiogramm (EKG) eingeschlossen. 80 Patienten mit Ausschluss einer interventionspflichtigen koronaren Herzkrankheit (KHK) wurden als Kontrollgruppe herangezogen.

Ergebnisse

STEMI-Patienten zeigten im Vergleich zur Kontrollgruppe keine signifikant höhere HCC (p = 0,846), ebenso bestand keine Korrelation zum Ausmaß eines Myokardinfarkts (p = 0,701, r = 0,038). Zusammenhänge zeigten sich zwischen der HCC, einem Diabetes mellitus (p = 0,046; Odds Ratio [OR] = 6,346), einer niedrigen HDL(„high-density lipoprotein“)-Cholesterin-Konzentration (p = 0,107) sowie HbA1c(Hämoglobin A1c)-Konzentration (p = 0,083; r = 0,236). Weiterhin stellten sich ein Zusammenhang zwischen einer erhöhten HCC und chronischer Herzinsuffizienz (p = 0,110) sowie Assoziationen zur RDW(„red blood cell distribution width“)-Konzentration (p = 0,005, r = 0,293) dar.

Schlussfolgerungen

Die vorliegenden Ergebnisse zeigen, dass Patienten mit akutem Myokardinfarkt im Vergleich zur Kontrollgruppe keine signifikant höheren Werte der HCC aufwiesen, jedoch langfristige metabolische Veränderungen sowie eine fortgeschrittene chronische Herzinsuffizienz Stressfaktoren für den Organismus zu sein scheinen und den Kortisolspiegel im Haar steigern.

Abstract

Introduction

Stress is a risk factor for the development of cardiovascular diseases. New analytical methods enable the determination of cortisol concentrations in hair (HCC) as a retrospective long-term parameter for chronic stress. So far, it is still uncertain whether stress objectively measured by an increase in HCC might be a predictive factor associated with the development of an acute myocardial infarction.

Methods

Included in this study were 40 patients 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).

Results

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).

Conclusion

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.

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  1. Medizinische Klinik II – Kardiologie und Angiologie, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland

    Helena Crom &  Hans-Joachim Trappe

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  1. Helena Crom
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Correspondence to Hans-Joachim Trappe.

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H. Crom und H.-J. Trappe geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Crom, H., Trappe, HJ. Haarkortisol als chronischer Stressparameter bei Patienten mit akutem ST-Strecken-Hebungs-Infarkt. Herz 46 (Suppl 2), 235–242 (2021). https://doi.org/10.1007/s00059-020-04990-4

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