Acromegaly per se does not increase the risk for coronary artery disease.
BACKGROUND
Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited.


OBJECTIVE
To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up.


METHODS
Twenty-five consecutive patients (age 45.1+/-10.6 years, 15 women) were studied at the time of diagnosis, and 19 patients were re-evaluated after 4.6+/-1.1 years. The European Society of Cardiology (ESC) risk score was calculated, and a cardiac computed tomography was performed for detection and quantification (Agatston score (AS)) of coronary artery calcium (CACs). Fifty age-, sex-, and CAD risk-matched subjects and CAC data from the population-based Heinz Nixdorf Recall (HNR) study served as controls.


RESULTS
In 21 of the 25 patients, the 10-year risk of developing CAD according to the ESC risk score was low (<10%) and high (>20%) in four patients. The AS was lower than in controls (2.6+/-7.9 vs 66+/-182; P=0.014) and less patients had a positive CAC (AS>0) (20 vs 48%, P=0.024), which in the acromegalic patients was less than expected from the HNR study. The AS did not correlate with GH excess or disease duration. In 19 acromegalic patients, who were in remission and re-evaluated after 4.6+/-1.1 years, the ESC risk (P=0.102) and the AS (P=0.173) did not change significantly and no symptomatic CAD event occurred.


CONCLUSIONS
CAD risk in newly diagnosed acromegalic patients was low and remained stable after successful treatment. CAC was lower than in controls suggesting that GH excess per se does not carry an additional CAD risk.
Akutsu
Hiroyoshi
H
Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Kreutzer
Jürgen
J
Wasmeier
Gerald
G
Ropers
Dieter
D
Rost
Christian
C
Möhlig
Matthias
M
Wallaschofski
Henri
H
Buchfelder
Michael
M
Schöfl
Christof
C
D000172:Acromegaly / Q000150:complications*; D000328:Adult; D002118:Calcium / Q000378:metabolism; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D014057:Tomography, X-Ray Computed
D002118:Calcium