TY  - BOOK
AU  - Mohammed Salah Ismail Yousef
AU  - Ahmed Elsherif , 
AU  - Randa Ali , 
AU  - Wael Samy , 
TI  - Relative adrenal insufficiency in acute coronary syndrome / 
PY  - 2015///
CY  - Cairo : 
PB  - Mohammed Salah Ismail Yousef , 
KW  - Acute coronary syndrome
KW  - Adrenal insufficiency
KW  - Mortality
N1  - Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine; Issued also as CD
N2  - Acute coronary syndrome (ACS) is an acute stressful condition which stimulates the hypothalamus - pituitary-adrenal axis (HPA) that regulates neurovascular and hormonal responses. Functional adrenal hypoadrenalism has been shown to be associated with significant morbidity and mortality in the critically ill patients. To determine the prevalence of adrenal insufficiency (by using low-dose and standard-dose ACTH stimulation tests) in patients with ACS and to correlate it with in - hospital morbidity and mortality. This study was conducted on thirty patients admitted with acute coronary syndrome. To all included patients short ACTH stimulation test was performed with a low-dose (1 og) ACTH stimulation test (LDT), followed by a standard dose (250 og) ACTH stimulation test (SDT) two hours later. The prevalence of adrenal insufficiency in our patients with was 56.7% (17 patients) and 33.3% (10 patients) by utilizing LDT and SDT, respectively. There was statistically significant higher basal serum cortisol levels by both LDT and SDT in non-survivors (33.2 ± 3.2 and 31.9 ± 2.5) compared to survivors(16.7 ± 6.6 and 16.9 ± 7.2) respectively, and statistically significant higher maximum change (x Max) in baseline cortisol in survivors compared to non-survivors (10.4 ± 3.6 Vs 6.2 ± 1.3) p value < 0.05 with LDT but not with the SDT
ER  -