Incidence of Venous Thromboembolism in Patients with Cushing's Syndrome: A Multicenter Cohort Study

Abstract

Patients with CS are at high risk of VTE, especially during active disease and after pituitary surgery. Guidelines on thromboprophylaxis are urgently needed.

D-dimer as a significant marker of deep vein thrombosis in patients with subclinical or overt Cushing’s syndrome

“…High prevalence of VTE has been shown in ACTH-dependent CS than -independent after surgery. However, overall incidence rates before surgery were similar between them [2]. No difference was seen between ACTH-dependent and -independent in study 1, is compatible with the previous report.…”

“…2b shows the D-dimer values with the highest areas under the generally used for DVT diagnosis; this technique has a sensitivity of 97-100% and a specificity of 98-99% for proximal thrombosis [24,25] but reduced accuracy for distal thrombosis (sensitivity, 70% and specificity, 60%) [12]. We found that 7 of the 19 patients with soCS exhibited DVT (37%), which was higher than a previously reported incidence [2]. The higher prevalence of DVT might be because of the indication bias from LEU.…”

“…To prevent VTE in these patients, early VTE (particularly DVT) screening and diagnosis are very important [10,11]. VTE is a frequent complication in patients with CS, especially during and after surgery [2,3], and thromboprophylaxis has been recommended for patients with active CS. However, thromboprophylaxis carries some inherent risks such as bleeding events.…”

“…Although anti-thrombotic prophylaxis has been recommended for patients with CS, particularly during the active disease phase and after transsphenoidal surgery [2], there are currently no established guidelines for antithrombotic therapy. The present study suggests that the D-dimer measurement is a useful marker for predicting DVT in patients with soCS and that the DVT detection cut-off value might differ among these patients relative to the general population.…”

“…Recently, VWF gene promoter polymorphisms have been reported to increase the risk of VTE via elevated levels of VWF in CS patients [7]. Although the risk of VTE is as high as 14.6 per 1000 person-years [2], the optimal VTE prediction marker in patients with CS remains to be determined. Disturbances in the hemostatic coagulation system have also been observed in patients with subclinical Cushing's syndrome [8,9].…”