Total and unbound Cortisol‐, progesterone‐, oestrone‐ and transcortin‐binding activities in sera from patients with myocardial infarction: evidence for differential responses of good and bad prognostic cases

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Abstract
Day-of-admission sera from myocardial infarction patients (MI) and patients with cardiopathies other than MI (non-MI) were analysed for total and unbound Cortisol (F), progesterone (P4), oestrone (E1), and corticosteroid binding activities (CBG). The MI who survived (n= 28) showed high increases of F, P4 and E1 compared to healthy controls. By contrast, the MI who died within 10 days of admission (n= 6) had unchanged F and less increased P4 and E1 than survivors. The non-MI (n= 6) had higher F and E1 than controls but normal P4. The unbound steroids were increased in all patients: however, the MI who died showed much smaller rises than survivors (P< 0±001 for unbound F and E1 increases in survivors vs. deceased). The CBG activity was in all MI lower than in normals (P<0±001) but unchanged in non-MI. These results are discussed in terms of the potential significance of unbound plasma steroids as predictors of MI severity.