title: Surgical remission of Cushing's syndrome reduces cardiovascular risk.
abstract: OBJECTIVE
  Recent studies have questioned the reversibility of complications of Cushing's syndrome (CS) after successful surgical treatment. The aim of this study was to assess the outcome of patients with CS who achieved disease remission compared with those patients with persistent hypercortisolism and matched controls.
  
  
  METHODS
  A retrospective study of 75 patients with CS followed at an academic center.
  
  
  METHODS
  Cardiovascular risk profile was evaluated in 51 patients with CS in remission (group 1) and 24 patients with persistent disease (group 2) and compared with 60 controls. Mortality of patients with CS was compared with the background population.
  
  
  RESULTS
  In group 1, the frequency of cardiovascular risk factors dropped after disease remission even if it remained higher at the last follow-up than in the control group. In group 2, the frequency of cardiovascular risk factors remained unchanged during follow-up. The rate of cardiovascular and thromboembolic events was higher in group 2 than in group 1, as was the mortality rate (two deaths in group 1 and nine in group 2; ratio of two SMRs, 0.11; 95% CI, 0.011-0.512). Survival was significantly longer in group 1 than in group 2 (87 months, 80-98 vs 48 months, 38-62; P<0.0001).
  
  
  CONCLUSIONS
  Successful surgical treatment of hypercortisolism significantly improves cardiovascular risk and may reduce the mortality rate. Patients with persistent disease have increased morbidity and mortality when compared with patients in remission.
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Terzolo
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Allasino
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pia
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Peraga
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Daffara
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Laino
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ardito
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Termine
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Paccotti
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Berchialla
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Migliaretti
authors.affiliation: Internal Medicine IStatistical UnitDepartment of Clinical and Biological Sciences, University of Turin, A.O.U. San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Italy giuseppe.reimondo@unito.it.
authors.forename: G
authors.initials: G
authors.lastname: Reimondo
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000473:pathology*; D003480:Cushing Syndrome / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies