IS THE RISK OF SUDDEN CARDIAC DEATH INCREASED IN CUSHING'S DISEASE AND SYNDROME?

Sudden cardiac death (SCD) is a widespread and devastating event. As much as a quarter or half of all cardiovascular (CV) deaths are due to SCD. A lot of work is done to decrease the number of SCD. Recently several publications pointed out (very) high CV risk in Cushing's syndrome (CS) and CV risk is generally associated with SCD. Therefore, the aim of the study is to analyze the available publications regarding CS and SCD.

We initiated the search in SCOPUS using the terms "Cushing" and "sudden death". The additional documents were retrieved from Medline, Springer, SAGE, Science Direct, Cambridge, Wiley, PubMed, and Oxford Journals. There are no trials or registries published and therefore the narrative review is an appropriate approach to describe the problem, appraise the available evidence, and propose a solution.

There are four papers available from SCOPUS and four additional papers from other sources. The oldest paper on the topic is almost a century old (from 1927), the last one 33 years old, suggesting that this problem (SCD in CS) was not considered important for three decades. Therefore, a paucity of papers analyzed SCD risk in CS. We managed to identify several RFs of SCD that are prevalent in CS.

Clustering of SCD risk factors suggest increased risk of SCD in Cushing disease (CD) and CS. The risk stratification tools for CV events should be studied, particularly so for SCD. Preventive measures should be tailored to the level of CV risk in individual CS patients. In addition, it carries a promise of prevention in individual patients, since SCD is preventable in part.