The Role of Stress in Cardiac Arrest (Cortizol CPR) (Cortizol)

Stress as a Key Factor Influencing the Onset and Course of Cardiac Arrest

The aim of this study is to assess long-term stress in patients after an out-of-hospital cardiac arrest. To do this, we will measure levels of the stress hormone cortisol in hair samples. Cortisol is produced in larger amounts during periods of ongoing stress and builds up in the hair as it grows. Because hair grows about 1 cm per month, a 3 cm hair sample can show your average stress level over the past three months. The results will be compared with anonymized information from your medical records and the care you received before and during your hospital stay.

Study Overview

• Status: Recruiting
• Conditions: Cardiac Arrest (CA); Heart Attack; Chronic Stress; Post-Resuscitation Syndrome
• Intervention / Treatment: Diagnostic test: Sample of hair

Detailed Description

Despite significant advances in resuscitation medicine, out-of-hospital cardiac arrest (OHCA) continues to carry a poor prognosis, with survival accompanied by good neurological outcomes in only about 30% of cases. In Europe, OHCA affects approximately 67-170 individuals per 100,000 annually; in the Czech Republic, the incidence is around 90 per 100,000. Most cardiac arrests (60-70%) are of cardiovascular origin, where long-term stress is a known contributing risk factor.

Chronic stress not only influences the development of cardiovascular disease but also affects its clinical manifestation by modulating the autonomic nervous system-an essential regulator of heart rhythm and arrhythmogenic risk. Therefore, it is plausible that prolonged stress also contributes to the onset and course of cardiac arrest.

While the relationship between chronic stress and cardiovascular disease has been well documented, data specifically linking stress to out-of-hospital cardiac arrest are still lacking. The pathophysiological factors influencing the onset and refractoriness of OHCA also remain unclear.

This study aims to evaluate chronic stress levels in patients after OHCA by measuring cortisol concentrations in hair samples. Since cortisol accumulates in hair during its growth, a 3 cm segment reflects stress exposure over the previous three months. These findings will be correlated with patients' demographic and clinical profiles, including post-resuscitation condition severity, neurological outcomes, and potential arrest refractoriness.

• Study Type: Interventional
• Enrollment (Estimated): 136
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jana Smalcova, MD, Ph.D.; Phone Number: +420 775 360 017; Email: jana.smalcova@gmail.com
• Study Contact Backup: Name: Milan Hromadka, MD, Ph.D.; Phone Number: +420 377 105 840; Email: hromadka@fnplzen.cz

Study Locations

• Czechia
  • Czech Republic
    • Pilsen, Czech Republic, Czechia, 30100
      • Recruiting
      • University Hospital Pilsen
      • Contact: Jana Smalcova, MD, Ph.D.; Phone Number: +420 775 360 017; Email: jana.smalcova@gmail.com
      • Contact: Milan Hromadka, MD, Ph.D.; Phone Number: +420 377 105 840; Email: hromadka@fnplzen.cz
      • Principal Investigator: Jana Smalcova, MD, Ph.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Cardiac arrest
• Heart attack
• 18 - 100 years

Exclusion Criteria:

• Disapproval patient´s relatives with the study
• Chronical treatment with corticoids and antidepresives

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cardiac arrest	Diagnostic test: Sample of hair; Sampling of 3cm of hair due to level of cortizol.
Experimental: Heart attack	Diagnostic test: Sample of hair; Sampling of 3cm of hair due to level of cortizol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hair cortisol levels assessment in CA patients vs heart attack patients	Hair cortisol levels assessment in CA patients vs heart attack patients	Enrollment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation of neurological outcomes using the CPC scale in CA patients with hair cortisol levels.	Correlation of neurological outcomes using the CPC scale in CA patients with hair cortisol levels.	30 and 90 days after CA
Correlation between the severity of the post-resuscitation course according to the severity of organ damage (heart, lung, kidneys, brain ) and hair cortisol levels	Correlation between the severity of the post-resuscitation course according to the severity of organ damage (heart, lung, kidneys, brain ) and hair cortisol levels	30 days after CA

Collaborators and Investigators

• Sponsor: University Hospital Pilsen

Study record dates

Study Major Dates

• Study Start (Actual): January 8, 2026
• Primary Completion (Estimated): July 31, 2027
• Study Completion (Estimated): October 31, 2027

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: December 2, 2025
• First Posted (Actual): December 16, 2025

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: cardiac arrest; hair; chronic stress; kortizol
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Pathologic Processes; Heart Diseases; Infarction; Necrosis; Myocardial Ischemia; Ischemia; Pathological Conditions, Signs and Symptoms; Heart Arrest; Myocardial Infarction
• Other Study ID Numbers: Stress

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No