title: A pilot study investigating the effect of parathyroidectomy on arterial stiffness and coronary artery calcification in patients with primary hyperparathyroidism.
abstract: BACKGROUND
  Arterial stiffness (AS) and coronary artery calcification (CAC) are predictors of cardiovascular risk and can be measured noninvasively. The aim of this study was to analyze the effects of parathyroidectomy on AS and CAC in patients with primary hyperparathyroidism (PHP).
  
  
  METHODS
  This prospective, institutional review board-approved study included 21 patients with PHP, who underwent parathyroidectomy. Before and 6 months after parathyroidectomy, AS was assessed by measuring central systolic pressure (CSP), central pulse pressure, augmentation pressure (AP), and augmentation index (AIx); the CAC score (Agatston) was calculated on noncontrast computed tomography. AS parameters were compared with unaffected controls from donor nephrectomy database.
  
  
  RESULTS
  Preoperative CSP and AIx parameters in PHP patients were higher than those in donor nephrectomy patients (P = .004 and P = .039, respectively). Preoperative total CAC score was zero in 15 patients (65%) and ranged from the 72nd to the 99th percentile in 6 patients (26%). Although there were no changes in CAC or AS after parathyroidectomy on average, there was variability in individual patient responses on AS.
  
  
  CONCLUSIONS
  This pilot study demonstrates that CAC is not altered in PHP patients at short-term follow-up after parathyroidectomy. The heterogeneous changes in AS after parathyroidectomy warrant further investigation in a larger study with longer follow-up.
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Cem
authors.initials: C
authors.lastname: Dural
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Alexis Kofi
authors.initials: AK
authors.lastname: Okoh
authors.affiliation: Department of Epidemiology and Biostatistics, Division of Health Service Research, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Andreea
authors.initials: A
authors.lastname: Seicean
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yigitbas
authors.affiliation: Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH.
authors.forename: George
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Pinar
authors.initials: P
authors.lastname: Yazici
authors.affiliation: Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Paul
authors.initials: P
authors.lastname: Shoenhagen
authors.affiliation: Department of Endocrinology, Cleveland Clinic, Cleveland, OH.
authors.forename: Krupa
authors.initials: K
authors.lastname: Doshi
authors.affiliation: Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Sandra
authors.initials: S
authors.lastname: Halliburton
authors.affiliation: Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH. Electronic address: berbere@ccf.org.
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D059289:Vascular Stiffness