{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:23:23Z","timestamp":1769127803194,"version":"3.49.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T00:00:00Z","timestamp":1506988800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eur J Prev Cardiolog"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Glucocorticoid excess has been linked with cardiovascular disease. Little is known about the long-term cortisol response in patients after acute coronary syndrome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p> The objective of this study was to describe the distribution of salivary cortisol in the post-acute phase of acute coronary syndrome and to describe the association of late-night salivary cortisol with cardiovascular risk factors. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> We used late-night salivary cortisol measurements post-discharge to estimate hypothalamic-pituitary-adrenal axis activity in 309 patients aged 18\u201355 years enrolled in the GENESIS-PRAXY study from January 2009\u2013April 2013. We evaluated hypothalamic-pituitary-adrenal axis activity and its association with hypertension, dyslipidemia, diabetes, smoking, family history, prior acute coronary syndrome, psychiatric diseases, acute coronary syndrome severity, as well as mortality and rate of rehospitalization at 12 months. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Persistently elevated late-night salivary cortisol&gt;2.92\u2009nmol\/l was seen in 99 (32.0%) patients: within the range of what may be seen in Cushing\u2019s disease. Elevated late-night salivary cortisol was associated with previous acute coronary syndrome (13.3% vs 24.2%, p\u2009=\u20090.02), peripheral vascular disease (3.8% vs 13.1%, p\u2009=\u20090.002), and smoking (32.9% vs 46.5% p\u2009=\u20090.02). Elevated late-night salivary cortisol was associated with higher hemoglobin A1c values (5.6\u2009\u00b1\u20093.0 vs 6.1\u2009\u00b1\u20092.9, p\u2009=\u20090.008) and lower high density lipoprotein values (0.94\u2009\u00b1\u20090.53 vs 0.86\u2009\u00b1\u20090.50, p\u2009=\u20090.01). There were no differences in psychiatric symptom scores, acute coronary syndrome severity or mortality, and rate of rehospitalization at 12 months. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Many patients post-acute coronary syndrome have prolonged, marked activation of the hypothalamic-pituitary-adrenal axis. Late-night salivary cortisol co-associates with several cardiovascular risk factors. Further studies are needed to confirm the exact role of hypothalamic-pituitary-adrenal axis activity in the pathophysiology of cardiovascular disease. <\/jats:p><\/jats:sec>","DOI":"10.1177\/2047487317734323","type":"journal-article","created":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T16:48:10Z","timestamp":1507049290000},"page":"65-72","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Prolonged hypothalamic-pituitary-adrenal axis activation after acute coronary syndrome in the GENESIS-PRAXY cohort"],"prefix":"10.1093","volume":"25","author":[{"given":"Andrew R","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen M","family":"Rabi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim L","family":"Lavoie","sequence":"additional","affiliation":[{"name":"Montreal Behavioural Medicine Centre, Hopital du Sacre-Coeur de Montreal, Canada"},{"name":"Department of Psychology, Universit\u00e9 du Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon L","family":"Bacon","sequence":"additional","affiliation":[{"name":"Montreal Behavioural Medicine Centre, Hopital du Sacre-Coeur de Montreal, Canada"},{"name":"Department of Exercise Science, Concordia University, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Pilote","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory A","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Medicine, 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