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Patients with Cushing's syndrome suffer from provoked venous thromboembolism and are anticoagulated in various

Agata Hanna Bryk-Wiązania1,2, Mari Minasyan2, Alicja Hubalewska-Dydejczyk1,2

  • 1Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland.

Endocrine Connections
|July 20, 2024
PubMed

Insights

Cushing's syndrome patients experiencing venous thromboembolism (VTE) had provoked episodes mainly due to transient factors. Anticoagulant regimens varied, highlighting the need for validated risk scores and treatment guidelines.

Area of Science:

  • Endocrinology
  • Hematology
  • Clinical Medicine

Background:

  • Cushing's syndrome (CS) significantly increases venous thromboembolism (VTE) risk (18-fold).
  • Identifying VTE triggers and optimal anticoagulation in CS patients is crucial for management.

Purpose of the Study:

  • To identify factors provoking VTE in patients with CS and VTE.
  • To describe the anticoagulant regimens used in these cases.

Main Methods:

  • Retrospective observational study of patients in the European Registry on CS (ERCUSYN).
  • VTE provocation factors assessed using International Society of Thrombosis and Hemostasis (ISTH) guidance, Padua score, and CS-VTE score.
  • Anticoagulant treatments and durations were recorded.

Main Results:

  • Nine patients experienced ten VTE episodes over a median of 4.3 years (7.8% prevalence).
  • All VTEs were provoked, primarily by transient major (50%) and minor (20%) factors.
  • Anticoagulation primarily involved vitamin K antagonists (4/8), direct oral anticoagulants (3/8), and low-molecular-weight heparin (1/8); median duration was 2.75 years.

Conclusions:

  • Further multicenter studies are needed.
  • Development of a validated thrombotic risk score and treatment guidelines for VTE in CS patients is recommended.
Abstract

Keywords:
Cushing’s diseaseCushing’s syndromeanticoagulantsrisk factors for venous thromboembolismvenous thromboembolism

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