title: Coronary artery disease detected by multislice computed tomography in patients after long-term cure of Cushing's syndrome.
abstract: OBJECTIVE
  Increased cardiovascular risk persists in Cushing's syndrome (CS), despite remission of hypercortisolism. The aim of this study was to evaluate the prevalence of coronary artery disease in patients after long-term cure of CS.
  
  
  METHODS
  Cardiac multidetector computed tomography was performed in 29 cured CS patients (5 men, 21 of pituitary origin, 50 ± 13 y, mean time of "cure" 11 ± 6 y), using 64-slice Toshiba Aquilion systems (Toshiba Medical Systems, Otawara, Japan). Noncontrast acquisitions were performed to detect coronary calcifications and, after injection of an iodinated contrast agent, for coronary angiography. Calcium was quantified by the Agatston score. Cured patients were compared with 48 gender-matched and age-matched healthy controls.
  
  
  RESULTS
  Cured CS patients had more hypertension and smoked less than controls (P < .05). The prevalence of coronary calcifications (31% vs 21%) and noncalcified plaques (20% vs 7.8%) tended to be higher in cured CS patients than controls. When only women were analyzed (24 CS and 34 controls), more abnormal multidetector computed tomography results were found (42% vs 18%; P < .05). When patients and controls in the youngest tertile (<45 y) were compared, cured CS patients had significantly more noncalcified plaques than controls (30% vs 0%, P = .01); this difference persisted when hypopituitary or dyslipidemic CS patients were excluded.
  
  
  CONCLUSIONS
  Despite long-term biochemical "cure" of CS, patients exhibit more coronary artery disease, especially in women and in those aged <45 years, in comparison to healthy matched controls.
authors: Department of Endocrinology, Hospital Universitari Mútua de Terrassa, Plaça Doctor Robert 5, 08221 Terrassa, Barcelona, Spain. 33962mbc@comb.cat
authors: María-José
authors: MJ
authors: Barahona
authors: Eugenia
authors: E
authors: Resmini
authors: David
authors: D
authors: Viladés
authors: Guillem
authors: G
authors: Pons-Lladó
authors: Rubén
authors: R
authors: Leta
authors: Teresa
authors: T
authors: Puig
authors: Susan M
authors: SM
authors: Webb
mesh_terms: D000328:Adult; D017677:Age Distribution; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D057791:Cardiac Imaging Techniques; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003480:Cushing Syndrome / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D012074:Remission Induction; D012307:Risk Factors; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed