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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Low risk of coronary artery disease in patients with acromegaly
Cintia Marques Dos Santos Silva1, G A B Lima2, I C M Volschan3
1Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil. cintiasilva.marques@bol.com.br.
Insights
Acromegaly patients show a low risk of coronary artery disease, despite high rates of hypertension and diabetes. Coronary artery calcium scores were similar between acromegalic and control groups, indicating no increased cardiovascular event risk.
Area of Science:
- Endocrinology
- Cardiology
- Radiology
Background:
- Acromegaly is associated with metabolic abnormalities like hypertension, diabetes, and hypercholesterolemia.
- These conditions increase the risk of cardiovascular disease.
- The prevalence of coronary atherosclerosis in acromegalic patients requires further investigation.
Purpose of the Study:
- To determine the prevalence of coronary atherosclerosis in acromegalic patients.
- To investigate the relationship between coronary artery calcium score (CS) and acromegaly status.
- To explore the association between CS, acromegaly, and clinical parameters like Framingham risk score (FRS).
Main Methods:
- Fifty-six acromegalic patients and matched controls were stratified by FRS (low, intermediate, high).
- Coronary artery calcium score (CS) was assessed using multidetector computed tomography.
- Acromegaly status was categorized as controlled or active.
Main Results:
- Acromegalic patients had high prevalence of hypertension (66%), diabetes (36%), and hypercholesterolemia (34%).
- Median FRS and 10-year cardiovascular event risk were similar between acromegalics and controls.
- Median total CS and CS >75th percentile did not differ significantly between groups; 72% had CS = 0.
Conclusions:
- Despite metabolic abnormalities, acromegalic patients exhibit a low risk of coronary artery disease based on FRS and CS.
- No significant differences in CS or cardiovascular risk were found between controlled and active acromegaly groups.
- Coronary atherosclerosis risk in acromegaly appears low, irrespective of disease activity or metabolic comorbidities.
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.
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