Chronic adrenocortical activity and onset of Takotsubo syndrome.
Elena Salmoirago-Blotcher, Natalie G Keirns, Sara Ouaddi and 4 others
PMID 41562264WHAT IT FOUND
Hair cortisol was twice as high in 59 Takotsubo patients than in historical controls, but it did not track reported triggers or predict post-discharge psychological distress.
Key findings
01The hair cortisol geometric mean was 7.3 pg/mg in the Takotsubo sample and 3.5 pg/mg in the Whitehall historical control cohort (p < .01).
02After adjustment for health insurance source, diabetes history, and hypertension history, hair cortisol was not associated with trigger status (β = −.11, 95% CI: −.32, .14).
03Higher hair cortisol did not predict greater post-discharge psychological distress in models controlling for age, financial status, and marital status (p > .05).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The Takotsubo group was compared with historical controls, not people recruited and assessed at the same time. Hair cortisol was measured using different laboratory methods in the two groups, so part of the difference could be method-related. The raw data from the Whitehall cohort were not available, so the researchers could not use propensity scores or fully adjust for differences between the groups. The patient sample was small (59 analysed) and mostly women and white participants, so the findings may not apply to men or other groups. Hair cortisol did not correlate with trigger status or post-discharge distress, so it may not capture subjective stress in this setting.
Declared interests
The authors declared no conflicts of interest or financial relationships with industry.
The easy way to misread this
Do not conclude that chronic stress caused Takotsubo syndrome or that hair cortisol can guide patient care. The study compared patients with historical controls measured by a different method, and hair cortisol did not predict post-discharge distress or correlate with reported triggers.