High prevalence of venous thrombotic events in Cushing's syndrome: data from ERCUSYN and details in relation to surgery


Por: Isand, K, Feelders, R, Brue, T, Toth, M, Deutschbein, T, Reincke, M, Krsek, M, Santos, A, Demtröder, F, Chabre, O, Strasburger, CJ, Maso, AA, Volke, V, Pereira, AM, Lohmann, R, Saladich, IG, Webb, SM, Wass, J, Valassi, E

Publicada: 3 ene 2024 Ahead of Print: 1 ene 2024
Resumen:
Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE.Design: A retrospective observational cohort study.Methods Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database.Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely.Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.

Filiaciones:
Isand, K:
 Univ Tartu, Inst Biomed & Translat Med, Ulikooli 18, EE-50090 Tartu, Estonia

Feelders, R:
 ENETS Ctr Excellence, Dept Internal Med, Sect Endocrinol, Erasmus MC, NL-3015 Rotterdam, Netherlands

 Erasmus Canc Inst, NL-3015 Rotterdam, Netherlands

Brue, T:
 Aix Marseille Univ, MarMaRa Inst, Hosp Concept, APHM,INSERM,MMG,Dept Endocrinol, F-13305 Marseille, France

Toth, M:
 Semmelwe Univ, Dept Internal Med & Oncol, H-1083 Budapest, Hungary

Deutschbein, T:
 Univ Wurzburg, Univ Hosp, Dept Internal Med 1, Div Endocrinol & Diabet, D-97080 Wurzburg, Germany

Reincke, M:
 Ludwig Maximilians Univ Munchen, Klinikum Univ Munchen, Med Klin & Poliklin 4, Campus Innenstadt, D-80336 Munich, Germany

Krsek, M:
 Charles Univ Prague, Gen Univ Hosp, Fac Med 1, Dept Internal Med 3, Prague 12808, Czech Republic

Santos, A:
 UAB, Hosp Sant Pau, Dept Med, IIB Sant Pau, Barcelona 08025, Spain

 UAB, Hosp Sant Pau, Dept Endocrinol, Dept Med, Barcelona 08025, Spain

 Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, ISCIII, Barcelona 08025, Spain

 Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Barcelona, Spain

Demtröder, F:
 Zent Endokrinol Diabetol Rheumatol Dr Demtroder &, D-44137 Dortmund, Germany

Chabre, O:
 Univ Grenoble Alpes, Endocrinol CHU Grenoble Alpes, INSERM, CEA,UGA,UMR 1292, F-38000 Grenoble, France

Strasburger, CJ:
 Charite, Clin Endocrinol, Campus Mitte, D-10117 Berlin, Germany

Volke, V:
 Univ Tartu, Inst Biomed & Translat Med, Ulikooli 18, EE-50090 Tartu, Estonia

Webb, SM:
 UAB, Hosp Sant Pau, Dept Med, IIB Sant Pau, Barcelona 08025, Spain

 UAB, Hosp Sant Pau, Dept Endocrinol, Dept Med, Barcelona 08025, Spain

 Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, ISCIII, Barcelona 08025, Spain

 Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Barcelona, Spain

Wass, J:
 Oxford Univ Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford OX37LE, England

Valassi, E:
 Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Barcelona, Spain

 Germans Trias I Pujol Hosp & Res Inst, Endocrinol & Nutr Dept, Badalona 08916, Spain

Univ Amsterdam, Dept Endocrinol & Metab, Med Ctr, NL-1081 Amsterdam, Netherlands
Univ Amsterdam, NL-1081 Amsterdam, Netherlands
Hlth Care Consulting GmbH, Lohmann & Birkner Hlth Care Consulting GmbH, D-13407 Berlin, Germany
Hosp Santa Creu I Sant Pau IIB Sant Pau, Dept Clin Epidemiol & Publ Hlth, Barcelona 08025, Spain
ISSN: 08044643
Editorial
BIOSCIENTIFICA LTD, STARLING HOUSE, 1600 BRISTOL PARKWAY N, BRISTOL, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 190 Número: 1
Páginas: 75-85
WOS Id: 001138735800001
ID de PubMed: 38146835
imagen hybrid, All Open Access; Hybrid Gold Open Access

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