ECE2011 Poster Presentations Pituitary (111 abstracts)
Cardiac risk in patients with treatment naïve, first-line medically controlled and first-line surgically cured acromegaly in comparison to matched data from the general population
Christian Berg 1 , Stephan Petersenn 1 , Burkhard Herrmann 1 , Ulla Roggenbuck 2 , Nils Lehmann 2 , Susanne Moebus 2 , Karl-Heinz Jöckel 2 , Stefan Moehlenkamp 3 , Raimund Erbel 3 & Klaus Mann 1
1Department of Endocrinolog and Laboratory Research, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany; 2Institute for Medical Informatics, Biometrie and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany; 3Department of Cardiology, West German Heart Centre, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
The influence of first-line transsphenoidal surgery (TSS) or first-line somatostatine analogue (SSA) treatment on coronary risk factors in patients with acromegaly has rarely been examined. Aim of this study was to evaluate risk factors for coronary heart disease in 3 different patient groups with treatment naïve, active (ACT), first-line medically controlled (MED) and first-line surgically treated (SUR) acromegaly and to calculate the Framingham Risk Score (FS).
Design: Retrospective-comparative-nonradomized-case-control study.
Patients and methods: Fourty acromegalic patients (28 men, 15 treatment-naïve, 13 SSA treated, 12 operated by TSS, aged 45–74 years) were matched for age and gender to 200 controls from the general population. Coronary risk factors were assessed by interviews and direct laboratory measurements. For purposes of the study, only controlled patients in MED and SUR group were included.
Results: Compared to matched controls ACT patients had increased prevalence of left ventricular hypertrophy (LVH) (30.8 vs 3.2% (P<0.001)), HbA1c (6.9±1.4 vs 5.4±0.7% (P<0.0001)), a trend of higher prevalence of hypertension (38.5 vs 36.9% (P=0.08)) and a FS in the high-risk group (22.0±22.7 vs 16.1±8.1% (P=0.81)). Odd’s ratio (OR) by multivariate conditional logistic regression for FS was 1.06 (0.99–1.13) (P=0.08). MED and SUR groups were similar for gender, age, disease duration and IGF1 levels. MED patients had a significantly increased diastolic blood pressure (89±9 vs 79±10 mmHg (P=0.001), prevalence of LVH (41.7 vs 1.7% (P<0.0001), BMI (31.3±5.2 vs 27.5±4.4 kg/m2 (P=0.02)), prevalence of diabetes mellitus (33.3 vs 10.0% (P=0.03)), HbA1c (6.8±1.3 vs 5.5±0.7% (P=0.0005)) and FS (21.2±9.7 vs 12.4±7.7% (P=0.002), OR 1.11 (1.01–1.21) (P=0.03)) while in SUR group only prevalence of LVH (40.0 vs 4.1% (P<0.001)) and HbA1c (6.4±1.2 vs 5.5±0.8% (P=0.006)) were significantly elevated but not FS (14.8±8.2 vs 12.6±8.1% (P=0.21), OR 1.07 (0.97–1.18) (P=0.19)).
Conclusion: When comparing treatment naive, medically treated and surgically cured patients with acromegaly to age- and gender-matched cohorts of the general population, we have found an significantly increased CV risk in patients 12 months after first-line SSA treatment but not in patients after first-line surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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