Low risk of coronary artery disease in patients with acromegaly
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ORIGINAL ARTICLE
Low risk of coronary artery disease in patients with acromegaly Cintia Marques dos Santos Silva1 • G. A. B. Lima2 • I. C. M. Volschan3 I. Gottlieb4 • L. Kasuki1,5 • L. Vieira Neto1,6 • M. R. Gadelha1
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Received: 17 February 2015 / Accepted: 5 May 2015 Ó Springer Science+Business Media New York 2015
Abstract The aims of this study are to determine the prevalence of coronary atherosclerosis in acromegalic patients and to investigate the relationship between the coronary artery calcium score (CS) and acromegaly status and clinical parameters [Framingham risk score (FRS)]. Fifty-six acromegalic patients and paired non-acromegalic volunteers were stratified according to the FRS into low-, intermediate-, and high-risk groups. CS was assessed using multidetector computed tomography. The patients were considered to have controlled or active acromegaly at the time they were submitted to evaluation. Sixty-six percent of acromegalic patients exhibited arterial hypertension, 36 % had diabetes mellitus, and 34 % had hypercholesterolemia. The median FRS and the median risk for cardiovascular event within the next 10 years were similar in the acromegalics and the controls. The median total CS and CS[75th percentile didn’t
differ significantly between these groups. In patients with controlled acromegaly, a low, intermediate, or high FRS risk was observed in 86, 14, and 0 %, respectively. In patients with active disease, a low, intermediate, or high FRS risk was verified in 94, 3, and 3 %, respectively, and differences between the controlled and active groups were not significant. Seventy-two percent of the patients had total CS = 0, and there were no differences between the controlled and active groups. The risk of coronary artery disease in acromegalic patients, determined according to FRS and CS, is low despite the high prevalence of metabolic abnormalities. Keywords Acromegaly Cardiac disease Framingham risk score Coronary artery calcium score
Introduction Cintia Marques dos Santos Silva and G. A. B. Lima have equally contributed to the development of the research and this paper.
Electronic supplementary material The online version of this article (doi:10.1007/s12020-015-0628-4) contains supplementary material, which is available to authorized users. & Cintia Marques dos Santos Silva [email protected] M. R. Gadelha [email protected] 1
2
Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universita´rio Clementino Fraga Filho – Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Funda˜o, Rio de Janeiro 21941-913, Brazil
Acromegaly is a rare disease that is typically caused by a growth hormone (GH)-secreting pituitary adenoma [1] and is characterized by increased serum GH and insulin-like growth factor type I (IGF-I) levels. Acromegaly may cause 3
Cardiology Section, Medical School and Hospital Universita´rio Clementino Fraga Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
4
Cl
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