High prevalence of venous thrombotic events in Cushing's syndrome :: data from ERCUSYN and details in relation to surgery

Kristina Isand; Richard Feelders; Thierry Brue; Miklos Toth; Timo Deutschbein; Martin Reincke; Michael Krsek; Alicia Santos; Frank Demtröder; Olivier Chabre; Christian J. Strasburger; Anna Aulinas Maso; Vallo Volke; Alberto M. Pereira; Rüdiger Lohmann; Ignasi Gich Saladich; Susana M Webb; John Wass; Elena Valassi; Cláudia Amaral; A. Ambrogio; G. Aranda; M. Arosio; M. Balomenaki; P. Beck-Peccoz; C. Berr-Kirmair; J. Bertherat; M. Bolanowski; J. Bollerslev; H. Cardoso; D. Carvalho; F. Cavagnini; P. Ceccato; P. Chanson; E. Christ; J. Denes; C. Dimopoulou; A. Dreval; M. Droste; J.S. Duarte; T. Dusek; E. Ertürk; J.A. Evang; C. Fajardo; J. Fazel; S. Fica; R. García-Centeno; E. Ghigo; M. Goth; Y. Greenman; I. Halperin; F.A. Hanzu; A. Hermus; Gudmundur Johannsson; E. Hubina; P. Kamenicky; A. Kasperlik-Zaluska; J. Kirchner; D. Kastelan; I. Komerdus; I. Kraljevic; A. Kruszynska; C. Lamas; I. Lambrescu; S. Lang; A. Luger; D. Maiter; N. Marpole; S. Martin; M. Martinie; M.J.M. Oliveira; O. Moros; R. Netea-Maier; J. Newell-Price; M. Orbetzova; I. Paiva; F.P. Giraldi; J.C. Percovich; M. Pfeiffer; J. Pickel; V. Pirags; O. Ragnarsson; A.D. Reghina; P. Riesgo; M. Roberts; S. Roerink; C. Rowan; P. Rudenko; M.A. Sahnoun; J. Salvador; Carla Scaroni; H.A. Sigurjonsdottir; T.S. Polovina; R. Smith; B. Stachowska; G. Stalla; Antoine Tabarin; M. Terzolo; J. Tőke; P. Touraine; P.J. Trainer; S. Tsagarakis; G. Vila; S. Vinay; Margreet Wagenmakers; S. Werner; Jacques Young; P. Zdunowski; Sabina Zacharieva; K. Zopf; S. Zopp; I. Zosin

doi:10.1093/ejendo/lvad176

High prevalence of venous thrombotic events in Cushing's syndrome : data from ERCUSYN and details in relation to surgery

Kristina Isand, Richard Feelders, Thierry Brue, Miklos Toth, Timo Deutschbein, Martin Reincke, Michael Krsek, Alicia Santos, Frank Demtröder, Olivier Chabre, Christian J. Strasburger, Anna Aulinas Maso, Vallo Volke, Alberto M. Pereira, Rüdiger Lohmann, Ignasi Gich Saladich, Susana M Webb, John Wass, Elena Valassi, Cláudia AmaralA. Ambrogio, G. Aranda, M. Arosio, M. Balomenaki, P. Beck-Peccoz, C. Berr-Kirmair, J. Bertherat, M. Bolanowski, J. Bollerslev, H. Cardoso, D. Carvalho, F. Cavagnini, P. Ceccato, P. Chanson, E. Christ, J. Denes, C. Dimopoulou, A. Dreval, M. Droste, J.S. Duarte, T. Dusek, E. Ertürk, J.A. Evang, C. Fajardo, J. Fazel, S. Fica, R. García-Centeno, E. Ghigo, M. Goth, Y. Greenman, I. Halperin, F.A. Hanzu, A. Hermus, Gudmundur Johannsson, E. Hubina, P. Kamenicky, A. Kasperlik-Zaluska, J. Kirchner, D. Kastelan, I. Komerdus, I. Kraljevic, A. Kruszynska, C. Lamas, I. Lambrescu, S. Lang, A. Luger, D. Maiter, N. Marpole, S. Martin, M. Martinie, M.J.M. Oliveira, O. Moros, R. Netea-Maier, J. Newell-Price, M. Orbetzova, I. Paiva, F.P. Giraldi, J.C. Percovich, M. Pfeiffer, J. Pickel, V. Pirags, O. Ragnarsson, A.D. Reghina, P. Riesgo, M. Roberts, S. Roerink, C. Rowan, P. Rudenko, M.A. Sahnoun, J. Salvador, Carla Scaroni, H.A. Sigurjonsdottir, T.S. Polovina, R. Smith, B. Stachowska, G. Stalla, Antoine Tabarin, M. Terzolo, J. Tőke, P. Touraine, P.J. Trainer, S. Tsagarakis, G. Vila, S. Vinay, Margreet Wagenmakers, S. Werner, Jacques Young, P. Zdunowski, Sabina Zacharieva, K. Zopf, S. Zopp, I. Zosin

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.

Original language	English
Pages (from-to)	75-85
Number of pages	11
Journal	Acta Endocrinologica, Supplement
Volume	190
Issue number	1
DOIs	https://doi.org/10.1093/ejendo/lvad176
Publication status	Published - 2024

Keywords

Cushing's syndrome
venous thromboembolism
risk factors
ERCUSYN

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10.1093/ejendo/lvad176

https://ddd.uab.cat/record/301954

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Isand, K., Feelders, R., Brue, T., Toth, M., Deutschbein, T., Reincke, M., Krsek, M., Santos, A., Demtröder, F., Chabre, O., Strasburger, C. J., Maso, A. A., Volke, V., Pereira, A. M., Lohmann, R., Saladich, I. G., Webb, S. M., Wass, J., Valassi, E., ... Zosin, I. (2024). High prevalence of venous thrombotic events in Cushing's syndrome : data from ERCUSYN and details in relation to surgery. Acta Endocrinologica, Supplement, 190(1), 75-85. https://doi.org/10.1093/ejendo/lvad176

@article{c3d4ecf966414d1f951985cfba3338e2,

title = "High prevalence of venous thrombotic events in Cushing's syndrome :: data from ERCUSYN and details in relation to surgery",

abstract = "Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.",

keywords = "Cushing's syndrome, venous thromboembolism, risk factors, ERCUSYN",

author = "Kristina Isand and Richard Feelders and Thierry Brue and Miklos Toth and Timo Deutschbein and Martin Reincke and Michael Krsek and Alicia Santos and Frank Demtr{\"o}der and Olivier Chabre and Strasburger, {Christian J.} and Maso, {Anna Aulinas} and Vallo Volke and Pereira, {Alberto M.} and R{\"u}diger Lohmann and Saladich, {Ignasi Gich} and Webb, {Susana M} and John Wass and Elena Valassi and Cl{\'a}udia Amaral and A. Ambrogio and G. Aranda and M. Arosio and M. Balomenaki and P. Beck-Peccoz and C. Berr-Kirmair and J. Bertherat and M. Bolanowski and J. Bollerslev and H. Cardoso and D. Carvalho and F. Cavagnini and P. Ceccato and P. Chanson and E. Christ and J. Denes and C. Dimopoulou and A. Dreval and M. Droste and J.S. Duarte and T. Dusek and E. Ert{\"u}rk and J.A. Evang and C. Fajardo and J. Fazel and S. Fica and R. Garc{\'i}a-Centeno and E. Ghigo and M. Goth and Y. Greenman and I. Halperin and F.A. Hanzu and A. Hermus and Gudmundur Johannsson and E. Hubina and P. Kamenicky and A. Kasperlik-Zaluska and J. Kirchner and D. Kastelan and I. Komerdus and I. Kraljevic and A. Kruszynska and C. Lamas and I. Lambrescu and S. Lang and A. Luger and D. Maiter and N. Marpole and S. Martin and M. Martinie and M.J.M. Oliveira and O. Moros and R. Netea-Maier and J. Newell-Price and M. Orbetzova and I. Paiva and F.P. Giraldi and J.C. Percovich and M. Pfeiffer and J. Pickel and V. Pirags and O. Ragnarsson and A.D. Reghina and P. Riesgo and M. Roberts and S. Roerink and C. Rowan and P. Rudenko and M.A. Sahnoun and J. Salvador and Carla Scaroni and H.A. Sigurjonsdottir and T.S. Polovina and R. Smith and B. Stachowska and G. Stalla and Antoine Tabarin and M. Terzolo and J. T{\H o}ke and P. Touraine and P.J. Trainer and S. Tsagarakis and G. Vila and S. Vinay and Margreet Wagenmakers and S. Werner and Jacques Young and P. Zdunowski and Sabina Zacharieva and K. Zopf and S. Zopp and I. Zosin",

year = "2024",

doi = "10.1093/ejendo/lvad176",

language = "English",

volume = "190",

pages = "75--85",

number = "1",

}

Isand, K, Feelders, R, Brue, T, Toth, M, Deutschbein, T, Reincke, M, Krsek, M, Santos, A, Demtröder, F, Chabre, O, Strasburger, CJ, Maso, AA, Volke, V, Pereira, AM, Lohmann, R, Saladich, IG, Webb, SM, Wass, J, Valassi, E, Amaral, C, Ambrogio, A, Aranda, G, Arosio, M, Balomenaki, M, Beck-Peccoz, P, Berr-Kirmair, C, Bertherat, J, Bolanowski, M, Bollerslev, J, Cardoso, H, Carvalho, D, Cavagnini, F, Ceccato, P, Chanson, P, Christ, E, Denes, J, Dimopoulou, C, Dreval, A, Droste, M, Duarte, JS, Dusek, T, Ertürk, E, Evang, JA, Fajardo, C, Fazel, J, Fica, S, García-Centeno, R, Ghigo, E, Goth, M, Greenman, Y, Halperin, I, Hanzu, FA, Hermus, A, Johannsson, G, Hubina, E, Kamenicky, P, Kasperlik-Zaluska, A, Kirchner, J, Kastelan, D, Komerdus, I, Kraljevic, I, Kruszynska, A, Lamas, C, Lambrescu, I, Lang, S, Luger, A, Maiter, D, Marpole, N, Martin, S, Martinie, M, Oliveira, MJM, Moros, O, Netea-Maier, R, Newell-Price, J, Orbetzova, M, Paiva, I, Giraldi, FP, Percovich, JC, Pfeiffer, M, Pickel, J, Pirags, V, Ragnarsson, O, Reghina, AD, Riesgo, P, Roberts, M, Roerink, S, Rowan, C, Rudenko, P, Sahnoun, MA, Salvador, J, Scaroni, C, Sigurjonsdottir, HA, Polovina, TS, Smith, R, Stachowska, B, Stalla, G, Tabarin, A, Terzolo, M, Tőke, J, Touraine, P, Trainer, PJ, Tsagarakis, S, Vila, G, Vinay, S, Wagenmakers, M, Werner, S, Young, J, Zdunowski, P, Zacharieva, S, Zopf, K, Zopp, S & Zosin, I 2024, 'High prevalence of venous thrombotic events in Cushing's syndrome : data from ERCUSYN and details in relation to surgery', Acta Endocrinologica, Supplement, vol. 190, no. 1, pp. 75-85. https://doi.org/10.1093/ejendo/lvad176

TY - JOUR

T1 - High prevalence of venous thrombotic events in Cushing's syndrome :

T2 - data from ERCUSYN and details in relation to surgery

AU - Isand, Kristina

AU - Feelders, Richard

AU - Brue, Thierry

AU - Toth, Miklos

AU - Deutschbein, Timo

AU - Reincke, Martin

AU - Krsek, Michael

AU - Santos, Alicia

AU - Demtröder, Frank

AU - Chabre, Olivier

AU - Strasburger, Christian J.

AU - Maso, Anna Aulinas

AU - Volke, Vallo

AU - Pereira, Alberto M.

AU - Lohmann, Rüdiger

AU - Saladich, Ignasi Gich

AU - Webb, Susana M

AU - Wass, John

AU - Valassi, Elena

AU - Amaral, Cláudia

AU - Ambrogio, A.

AU - Aranda, G.

AU - Arosio, M.

AU - Balomenaki, M.

AU - Beck-Peccoz, P.

AU - Berr-Kirmair, C.

AU - Bertherat, J.

AU - Bolanowski, M.

AU - Bollerslev, J.

AU - Cardoso, H.

AU - Carvalho, D.

AU - Cavagnini, F.

AU - Ceccato, P.

AU - Chanson, P.

AU - Christ, E.

AU - Denes, J.

AU - Dimopoulou, C.

AU - Dreval, A.

AU - Droste, M.

AU - Duarte, J.S.

AU - Dusek, T.

AU - Ertürk, E.

AU - Evang, J.A.

AU - Fajardo, C.

AU - Fazel, J.

AU - Fica, S.

AU - García-Centeno, R.

AU - Ghigo, E.

AU - Goth, M.

AU - Greenman, Y.

AU - Halperin, I.

AU - Hanzu, F.A.

AU - Hermus, A.

AU - Johannsson, Gudmundur

AU - Hubina, E.

AU - Kamenicky, P.

AU - Kasperlik-Zaluska, A.

AU - Kirchner, J.

AU - Kastelan, D.

AU - Komerdus, I.

AU - Kraljevic, I.

AU - Kruszynska, A.

AU - Lamas, C.

AU - Lambrescu, I.

AU - Lang, S.

AU - Luger, A.

AU - Maiter, D.

AU - Marpole, N.

AU - Martin, S.

AU - Martinie, M.

AU - Oliveira, M.J.M.

AU - Moros, O.

AU - Netea-Maier, R.

AU - Newell-Price, J.

AU - Orbetzova, M.

AU - Paiva, I.

AU - Giraldi, F.P.

AU - Percovich, J.C.

AU - Pfeiffer, M.

AU - Pickel, J.

AU - Pirags, V.

AU - Ragnarsson, O.

AU - Reghina, A.D.

AU - Riesgo, P.

AU - Roberts, M.

AU - Roerink, S.

AU - Rowan, C.

AU - Rudenko, P.

AU - Sahnoun, M.A.

AU - Salvador, J.

AU - Scaroni, Carla

AU - Sigurjonsdottir, H.A.

AU - Polovina, T.S.

AU - Smith, R.

AU - Stachowska, B.

AU - Stalla, G.

AU - Tabarin, Antoine

AU - Terzolo, M.

AU - Tőke, J.

AU - Touraine, P.

AU - Trainer, P.J.

AU - Tsagarakis, S.

AU - Vila, G.

AU - Vinay, S.

AU - Wagenmakers, Margreet

AU - Werner, S.

AU - Young, Jacques

AU - Zdunowski, P.

AU - Zacharieva, Sabina

AU - Zopf, K.

AU - Zopp, S.

AU - Zosin, I.

PY - 2024

Y1 - 2024

N2 - Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.

AB - Objective: The aim of this study was to evaluate the prevalence of venous thromboembolism (VTE) in patients included in the European Registry on Cushing's syndrome (ERCUSYN), compare their clinical characteristics with those who did not develop VTE and identify risk factors for VTE. Design: A retrospective observational cohort study. Methods: Data extraction from the registry was taken on February, 7, 2022. At the time there were 2174 patients diagnosed with Cushing's syndrome (CS) and 95 VTEs were reported in the database. Results: Of 95 VTE events 70 (74%) were in pituitary-dependent CS patients, 12 (12.5%) in adrenal-dependant CS, 10 (10.5%) in ectopic CS, and 3 (3%) in CS due to other causes. Sex, 24-hour urinary free cortisol (UFC) value at diagnosis, as well as the number of operations remained statistically significant predictors of VTE. Of patients who were treated with at least one surgery, 12 (13%) VTE occurred before and 80 (87%) after the surgery. Nearly half of these VTEs occurred within six months since the operation (36; 45%). Over half of the centers that reported VTE did not routinely anticoagulate CS patients. Anticoagulation schemes varied widely. Conclusion: Patients with CS have an elevated risk of developing VTE for an extended period of time. From ERCUSYN cohort patients have higher risk for VTE if they need multiple surgeries to treat CS, are males and have high UFC values at the diagnosis of CS. Since there is no agreement on thromboprohpylaxis, a protocol for VTE prevention that is widely adopted appears to be necessary for patients with CS.

KW - Cushing's syndrome

KW - venous thromboembolism

KW - risk factors

KW - ERCUSYN

U2 - 10.1093/ejendo/lvad176

DO - 10.1093/ejendo/lvad176

M3 - Article

C2 - 38146835

SN - 0300-9750

VL - 190

SP - 75

EP - 85

JO - Acta Endocrinologica, Supplement

JF - Acta Endocrinologica, Supplement

IS - 1

ER -

High prevalence of venous thrombotic events in Cushing's syndrome : data from ERCUSYN and details in relation to surgery

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