Risk Factors for Development of Coronary Heart Disease in Patients with Acromegaly: A Five-Year Prospective Study

Bogazzi, Fausto; Battolla, L; Spinelli, Cheti; Rossi, Giuseppe; Gavioli, Silvia; Bello, Vitantonio Di; Cosci, Chiara; Sardella, Chiara; Volterrani, Duccio; Talini, Enrica; Pepe, Pasquale; Falaschi, Fabio; Mariani, Giuliano; Martino, Enio

doi:10.1210/jc.2007-1213

Cited by 87 publications

(73 citation statements)

References 32 publications

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“…Whether hs-CRP is a nonspecific marker of the inflammation in atherosclerotic plaques or a direct participant in the progression of atherosclerosis remains an unsettled issue (28). Nevertheless, the present finding in acromegaly suggests less inflammation and a lower tendency to atheromatosis and this seems to be confirmed by clinical data (6,7). It could therefore be speculated that a low hs-CRP level in active acromegaly counteracts the risk caused by other cardiovascular risk factors, such as hypertension and diabetes.…”

Section: Discussionsupporting

confidence: 56%

“…In later stages, impaired systolic function evolving to heart failure may occur. In contrast, no increased prevalence of coronary artery disease was found in patients with newly diagnosed acromegaly (6,7). Similarly, the extent of carotid atherosclerosis and carotic internal media thickening in acromegalic patients was not higher than that in non-acromegalic subjects (6,8).…”

Section: Introductionmentioning

confidence: 71%

“…In contrast, no increased prevalence of coronary artery disease was found in patients with newly diagnosed acromegaly (6,7). Similarly, the extent of carotid atherosclerosis and carotic internal media thickening in acromegalic patients was not higher than that in non-acromegalic subjects (6,8). The reasons for this unexpected observation are still unclear, but this finding suggests that the known atherogenic effects of hypertension, insulin resistance, and diabetes induced by GH excess (9) are counterbalanced by cardioprotective factors (7).…”

Section: Introductionmentioning

confidence: 80%

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Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

Verhelst

Velkeniers²,

Maiter

et al. 2013

European Journal of Endocrinology

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Objective: Patients with active acromegaly have an increased prevalence of cardiomyopathy and heart failure but a less than expected risk of coronary artery disease, considering the frequent association of diabetes mellitus and hypertension. We examined whether changes in high-sensitive C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) might contribute to this phenomenon. Design and methods: Two hundred patients of the Belgian acromegaly registry (AcroBel) were divided in two groups: active disease (IGF1 Z-score O2; nZ95) and controlled disease (IGF1 Z-score %2; nZ105). Serum levels of hs-CRP and NT-proBNP were measured and correlated with BMI, blood pressure, fasting lipids, fasting glucose and insulin, HbA1c, IGF1, interleukin 6 (IL6), adiponectin, and sE-selectin. In a subset of acromegaly patients, hs-CRP, IL6, and NT-proBNP levels were also compared with those/the values of an age-, gender-, and BMI-matched reference group.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 80%

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Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

Verhelst

Velkeniers²,

Maiter

et al. 2013

European Journal of Endocrinology

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“…Many patients are exposed to coronary risk factors like arterial hypertension, diabetes mellitus, or dyslipidemia promoted by chronic GH excess (1,5). Information about CAD in acromegalic patients is limited and controversial (1,(5)(6)(7)(8)(9)(14)(15)(16). Many studies investigated heterogeneous cohorts that included treatment-naive acromegalic patients, patients with uncontrolled and treatment-resistant disease, and patients in remission who were with or without various treatment regimens.…”

Section: Discussionmentioning

confidence: 99%

“…In another prospective study, the risk of CAD was low, and none of the acromegalic patients developed a major cardiac event during the 5-year study period (15). Together, the data on CAD in acromegaly are limited, controversial, mainly refer to older pathological studies or are based on mixed patient populations comprising controlled and uncontrolled acromegaly without controls matched for CAD risk factors (1,(5)(6)(7)(8)(9)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Acromegaly per se does not increase the risk for coronary artery disease

Akutsu

Kreutzer²,

Wasmeier³

et al. 2010

European Journal of Endocrinology

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Context: Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited. Objective: To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up. Subjects and methods: Twenty-five consecutive patients (age 45.1G10.6 years, 15 women) were studied at the time of diagnosis, and 19 patients were re-evaluated after 4.6G1.1 years. The European Society of Cardiology (ESC) risk score was calculated, and a cardiac computed tomography was performed for detection and quantification (Agatston score (AS)) of coronary artery calcium (CACs). Fifty age-, sex-, and CAD risk-matched subjects and CAC data from the population-based Heinz Nixdorf Recall (HNR) study served as controls. Results: In 21 of the 25 patients, the 10-year risk of developing CAD according to the ESC risk score was low (!10%) and high (O20%) in four patients. The AS was lower than in controls (2.6G7.9 vs 66G182; PZ0.014) and less patients had a positive CAC (ASO0) (20 vs 48%, PZ0.024), which in the acromegalic patients was less than expected from the HNR study. The AS did not correlate with GH excess or disease duration. In 19 acromegalic patients, who were in remission and re-evaluated after 4.6G1.1 years, the ESC risk (PZ0.102) and the AS (PZ0.173) did not change significantly and no symptomatic CAD event occurred. Conclusion: CAD risk in newly diagnosed acromegalic patients was low and remained stable after successful treatment. CAC was lower than in controls suggesting that GH excess per se does not carry an additional CAD risk.

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Mortality and Morbidity in Acromegaly: Impact of Disease Control

Holdaway

2011

Growth Hormone Related Diseases and Therapy

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Risk Factors for Development of Coronary Heart Disease in Patients with Acromegaly: A Five-Year Prospective Study

Abstract: CHD risk in acromegalic patients, predicted by FS as in nonacromegalic subjects, is low; AS might have adjunctive role only in a subset of patients. However, most patients have systemic complications of acromegaly, which participate in the assessment of global CHD risk.

Cited by 87 publications

References 32 publications

Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

Acromegaly per se does not increase the risk for coronary artery disease

Mortality and Morbidity in Acromegaly: Impact of Disease Control

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