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THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN
Disclosure: K. Isand: None. R.A. Feelders: None. T.C. Brue: None. M. Toth: None. T. Deutschbein: None. M. Reincke: None. M. Krsek: None. A. Santos: None. F. Demtroder: None. O. Chabre: None. C.J. Strasburger: None. J.A. Wass: None. S.M. Webb: None. A. Aulinas Maso: None. V. Volke: None. E. Valassi:...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10554532/ http://dx.doi.org/10.1210/jendso/bvad114.1113 |
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author | Isand, Kristina Feelders, Richard Abraham Brue, Thierry Christian Toth, Miklos Deutschbein, Timo Reincke, Martin Krsek, Michal Santos, Alicia Demtroder, Frank Chabre, Olivier Strasburger, Christian Joseph Wass, John A H Webb, Susan M Maso, Ana Aulinas Volke, Vallo Valassi, Elena |
author_facet | Isand, Kristina Feelders, Richard Abraham Brue, Thierry Christian Toth, Miklos Deutschbein, Timo Reincke, Martin Krsek, Michal Santos, Alicia Demtroder, Frank Chabre, Olivier Strasburger, Christian Joseph Wass, John A H Webb, Susan M Maso, Ana Aulinas Volke, Vallo Valassi, Elena |
author_sort | Isand, Kristina |
collection | PubMed |
description | Disclosure: K. Isand: None. R.A. Feelders: None. T.C. Brue: None. M. Toth: None. T. Deutschbein: None. M. Reincke: None. M. Krsek: None. A. Santos: None. F. Demtroder: None. O. Chabre: None. C.J. Strasburger: None. J.A. Wass: None. S.M. Webb: None. A. Aulinas Maso: None. V. Volke: None. E. Valassi: None. For all ERCUSYN investigators Background: Patients with Cushing’s syndrome (CS) have increased risk of developing venous thromboembolic complications. The UK audit and meta-analysis of literature on Cushing’s disease (CD) over 50-years in Stoke-on-Trent by Clayton et al concluded that overall mortality in CD is double that of the general population. The risk of a thrombotic event (TE) (both arterial and venous) in patients with CS has been reported to be up to 10 times higher than that of the general population. When it comes to the cause of death, atherosclerotic diseases and venous thromboembolism (VTE) account for 43.4% of the deaths in patients with endogenous CS. Aim: To evaluate the prevalence of VTE in patients included in The European Registry on Cushing’s syndrome (ERCUSYN) and to study the details of each event to determine if there is any common line in patients who have been diagnosed with VTE. Methods: A retrospective observational cohort study; data extraction from the registry was taken on the 07.02.2022. Results: There were 95 VTE events among 2173 CS patients (prevalence of 4.4 %). Among the 57 centres included in the database (from 26 European countries), events were reported in 28 (from 16 countries). Patients were aged between 14-75 years, median age 47 years; 63(66%) were female. The 95 VTE events were observed in 70 (74%) pituitary-dependent, 12 (13%) adrenal-dependent, 10 (11%) ectopic and 3(3%) CS due to other causes. Comparing aetiologies, ectopic origin accounted for 10.5% of VTE patients and only 5% of those without VTE. Mean ± SD body mass index (BMI) reported in 68/95 patients was 28.8 ± 10.7 kg/m2, and more than three quarters (52; 76%) had a BMI above 25 kg/m2, being either overweight or obese; 21 (22%) patients were smoking. The most frequent comorbidity was hypertension (65 cases, 68%), followed by diabetes mellitus (40 cases, 42%) and osteoporosis (23, 24%); 7 (7%) had a cancer; 7 (7%) had active hypercortisolism (defined by elevated levels of midnight serum cortisol, urinary cortisol or cortisol day curve), 15 (16%) were in partial remission, 46 (48%) were cured and for 7 (7%) the status was unknown. Sixty-two (65%) had had 1 surgery, 22 (23%) had had two surgeries and 1 in the VTE group had 5 operations. Comparing groups, the VTE group had more surgeries than the no-VTE group. Mean operation rate per patient was 1.42 for the VTE group and 1.2 for no-VTE event group (p=0.0068). Seven (7%) patients died during the follow-up time (for different reasons). Conclusion: We report a high VTE rate in CS patients within ERCUSYN. Of note, to our knowledge this is the largest registry-based study to date looking at VTE in CS patients. Importantly, more than half of the VTE events were diagnosed in patients with normocortisolaemia. Presentation: Thursday, June 15, 2023 |
format | Online Article Text |
id | pubmed-10554532 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105545322023-10-06 THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN Isand, Kristina Feelders, Richard Abraham Brue, Thierry Christian Toth, Miklos Deutschbein, Timo Reincke, Martin Krsek, Michal Santos, Alicia Demtroder, Frank Chabre, Olivier Strasburger, Christian Joseph Wass, John A H Webb, Susan M Maso, Ana Aulinas Volke, Vallo Valassi, Elena J Endocr Soc Neuroendocrinology And Pituitary Disclosure: K. Isand: None. R.A. Feelders: None. T.C. Brue: None. M. Toth: None. T. Deutschbein: None. M. Reincke: None. M. Krsek: None. A. Santos: None. F. Demtroder: None. O. Chabre: None. C.J. Strasburger: None. J.A. Wass: None. S.M. Webb: None. A. Aulinas Maso: None. V. Volke: None. E. Valassi: None. For all ERCUSYN investigators Background: Patients with Cushing’s syndrome (CS) have increased risk of developing venous thromboembolic complications. The UK audit and meta-analysis of literature on Cushing’s disease (CD) over 50-years in Stoke-on-Trent by Clayton et al concluded that overall mortality in CD is double that of the general population. The risk of a thrombotic event (TE) (both arterial and venous) in patients with CS has been reported to be up to 10 times higher than that of the general population. When it comes to the cause of death, atherosclerotic diseases and venous thromboembolism (VTE) account for 43.4% of the deaths in patients with endogenous CS. Aim: To evaluate the prevalence of VTE in patients included in The European Registry on Cushing’s syndrome (ERCUSYN) and to study the details of each event to determine if there is any common line in patients who have been diagnosed with VTE. Methods: A retrospective observational cohort study; data extraction from the registry was taken on the 07.02.2022. Results: There were 95 VTE events among 2173 CS patients (prevalence of 4.4 %). Among the 57 centres included in the database (from 26 European countries), events were reported in 28 (from 16 countries). Patients were aged between 14-75 years, median age 47 years; 63(66%) were female. The 95 VTE events were observed in 70 (74%) pituitary-dependent, 12 (13%) adrenal-dependent, 10 (11%) ectopic and 3(3%) CS due to other causes. Comparing aetiologies, ectopic origin accounted for 10.5% of VTE patients and only 5% of those without VTE. Mean ± SD body mass index (BMI) reported in 68/95 patients was 28.8 ± 10.7 kg/m2, and more than three quarters (52; 76%) had a BMI above 25 kg/m2, being either overweight or obese; 21 (22%) patients were smoking. The most frequent comorbidity was hypertension (65 cases, 68%), followed by diabetes mellitus (40 cases, 42%) and osteoporosis (23, 24%); 7 (7%) had a cancer; 7 (7%) had active hypercortisolism (defined by elevated levels of midnight serum cortisol, urinary cortisol or cortisol day curve), 15 (16%) were in partial remission, 46 (48%) were cured and for 7 (7%) the status was unknown. Sixty-two (65%) had had 1 surgery, 22 (23%) had had two surgeries and 1 in the VTE group had 5 operations. Comparing groups, the VTE group had more surgeries than the no-VTE group. Mean operation rate per patient was 1.42 for the VTE group and 1.2 for no-VTE event group (p=0.0068). Seven (7%) patients died during the follow-up time (for different reasons). Conclusion: We report a high VTE rate in CS patients within ERCUSYN. Of note, to our knowledge this is the largest registry-based study to date looking at VTE in CS patients. Importantly, more than half of the VTE events were diagnosed in patients with normocortisolaemia. Presentation: Thursday, June 15, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10554532/ http://dx.doi.org/10.1210/jendso/bvad114.1113 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Neuroendocrinology And Pituitary Isand, Kristina Feelders, Richard Abraham Brue, Thierry Christian Toth, Miklos Deutschbein, Timo Reincke, Martin Krsek, Michal Santos, Alicia Demtroder, Frank Chabre, Olivier Strasburger, Christian Joseph Wass, John A H Webb, Susan M Maso, Ana Aulinas Volke, Vallo Valassi, Elena THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title | THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title_full | THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title_fullStr | THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title_full_unstemmed | THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title_short | THU033 High Prevalence Of Venous Thrombotic Events In Cushing’s Syndrome: Data From ERCUSYN |
title_sort | thu033 high prevalence of venous thrombotic events in cushing’s syndrome: data from ercusyn |
topic | Neuroendocrinology And Pituitary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10554532/ http://dx.doi.org/10.1210/jendso/bvad114.1113 |
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