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Published on: February 28, 2018

Cardiac risk in patients with treatment naïve, first-line medically controlled and first-line surgically cured

C Berg1, S Petersenn, M Walensi

  • 1Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany. christian.berg@uni-essen.de

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [And] German Diabetes Association
|January 23, 2013
PubMed
Abstract

Insights

Patients with acromegaly treated with somatostatine analogues (SSA) show increased cardiovascular risk. Acromegaly patients after surgery had no increased risk, highlighting surgery as a potentially safer first-line treatment for cardiovascular health.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Disorders

Background:

  • Acromegaly, a condition of excess growth hormone, presents significant cardiovascular risks.
  • Cardiovascular risk factors and outcomes after first-line treatments for acromegaly are not well-established.
  • Left ventricular hypertrophy (LVH) is a known complication of acromegaly.

Purpose of the Study:

  • To evaluate cardiovascular risk factors and LVH in patients with acromegaly after first-line treatment.
  • To compare risks between treatment-naïve, medically controlled (somatostatine analogue - SSA), and surgically treated (transsphenoidal surgery - TSS) acromegaly patients.
  • To calculate the Framingham Weibull Risk Score (FS) in these patient groups.

Main Methods:

  • Retrospective, matched case-control study comparing 40 acromegaly patients to 200 controls.
  • Patients were categorized into treatment-naïve (ACT), SSA-treated (MED), and TSS-treated (SUR) groups.
  • Cardiovascular risk factors, LVH, and FS were assessed 12 months post-treatment, including only IGF-I normalized patients in MED and SUR groups.

Main Results:

  • Treatment-naïve acromegaly patients showed higher HbA1c and LVH prevalence compared to controls.
  • SSA-treated patients exhibited increased diastolic blood pressure, LVH, diabetes mellitus, higher HbA1c, and a higher FS compared to controls.
  • Surgically treated patients showed increased LVH and HbA1c compared to controls, but the overall cardiovascular risk profile was less concerning than medically treated patients.

Conclusions:

  • First-line SSA treatment for acromegaly is associated with increased cardiovascular risk at 12 months.
  • First-line TSS for acromegaly does not appear to increase cardiovascular risk at 12 months.
  • These findings suggest that surgical intervention may be a preferable first-line treatment for managing cardiovascular health in acromegaly patients.

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