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

ERCUSYN Study Group

doi:10.1093/ejendo/lvad176

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

ERCUSYN Study Group

Institute of Biomedicine and Translational Medicine
University of Tartu
Department of Internal Medicine
Erasmus University Rotterdam
APHM
Aix-Marseille Université
Department of Internal Medicine and Oncology
Semmelweis University
Division of Endocrinology and Diabetes
University of Würzburg
Medizinische Klinik und Poliklinik IV
Ludwig Maximilian University of Munich
Third Department of Internal Medicine
Charles University
IIB-Sant Pau
Hospital de Sant Pau
Unidad 747)
Center for Biomedical Research On Rare Diseases (CIBERER)
Zentrum fur Endokrinologie
Klinikum Dortmund
Université Grenoble Alpes
Clinical Endocrinology
Charité – Universitätsmedizin Berlin
Department of Endocrinology and Metabolism
Amsterdam UMC
Lohmann & Birkner Health Care Consulting GmbH
Department of Clinical Epidemiology and Public Health
Oxford University Hospitals NHS Foundation Trust
Endocrinology and Nutrition Department
Generalitat de Catalunya
University Hospital Center of Santo António
University of Milan
Department of Endocrinology
Hospital Clinic de Barcelona
Unit of Endocrine Diseases & Diabetology
Evagelismos Hospital
Endocrinology and Diabetology Unit
Hôpital Cochin
Wrocław Medical University
Section of Specialized Endocrinology
University of Oslo
Association pour le Devéloppement des Recherches Biologiques et Médicales
Centro Hospitalar Universitário de São João
Endocrinology Unit
Azienda Ospedaliera di Padova
CHU de Grenoble
Université Paris-Saclay
Assistance Publique-Hôpitaux de Paris
Assistance publique – Hôpitaux de Paris
Inelspital
University of Bern
Division of Endocrinology
State Health Center
Medicover Oldenburg MVZ
Max-Planck-Gessellschaft Zur Forderung der Wissenschaften E.V.
M.F. Vladimirsky Moscow Regional Research and Clinical Institute
Praxis für Endokrinologie Droste
Serviço Endocrinologia CHLO
Santa Cruz Hospital
Department of Endocrinology
University of Zagreb
Uludag University
Hospital Universitario de la Ribera
Carol Davila University of Medicine and Pharmacy
Hospital General Universitario Gregorio Marañon
Molinette Hospital
Azienda Sanitaria Ospedaliera Molinette San Giovanni Battista Di Torino
Metabolism and Hypertension
Institute of Endocrinology
Radboud University Nijmegen
University of Gothenburg
Institut national de la santé et de la recherche médicale
Medical Centre for Postgraduate Education, Warsaw
Division of Clinical Endocrinology
2nd Department of Medicine
Endocrinology and Nutrition Department
Complejo Hospitalario Universitario de Albacete
Medical University of Vienna
Université catholique de Louvain
The Christie NHS Foundation Trust
Service d'Endocrinologie-Diabétologie-Nutrition
Centro Hospitalar Vila Nova Gaia/Espinho
University of Sheffield
Clinic of Endocrinology and Metabolic Diseases
Sv.Georgy University Hospital
University of Coimbra
Leiden University
University Medical Centre Ljubljana Department of Neurology
University of Latvia
Neurosurgery Department
Estonian Endocrine Society
Aix-Marseille Université
Hôpital Conception
University of Navarra
Landspitali University Hospital
University of Iceland
Department of Endocrinology
Université de Bordeaux
Internal Medicine—Endocrinology
Azienda Ospedaliera S. Luigi Gonzaga
GH Pitie Salpetriere
Sorbonne Université
Department of Endocrinology
Department of Endocrinology
Medical University Sofia
Romanian Society for Endocrinology
Erasmus MC

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

23 Downloads (Pure)

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	European Journal of Endocrinology
Volume	190
Issue number	1
DOIs	https://doi.org/10.1093/ejendo/lvad176
Publication status	Published - Jan 2024

Keywords

Cushing's syndrome
ERCUSYN
risk factors
venous thromboembolism

Access to Document

10.1093/ejendo/lvad176

High-prevalence-of-venous-thrombotic-events-in-cushings-syndrome.pdfFinal published version, 652 KBLicence: CC BY

Cite this

@article{12edb5b8bed7462cb71dd0748d0cb36e,

title = "High prevalence of venous thrombotic events in Cushing{\textquoteright}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, ERCUSYN, risk factors, venous thromboembolism",

author = "\{ERCUSYN Study Group\} and Kristina Isand and Richard Feelders and Thierry Brue and Miklos Toth and Timo Deutschbein and Martin Reincke and M. Krsek and A. Santos and Frank Demtr{\"o}der and O. Chabre and C. Strasburger and Maso, \{Anna Aulinas\} and Vallo Volke and Pereira, \{A. M.\} and R{\"u}diger Lohmann and Saladich, \{Ignasi Gich\} and Webb, \{Susan M.\} and John Wass and Elena Valassi and C. 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 Brue Thierry and H. Cardoso and D. Carvalho and F. Cavagnini and P. Ceccato and O. Chabre and P. Chanson and E. Christ and Demtr{\"o}der, \{F. A.\} and J. Denes and T. Deutschbein and C. Dimopoulou and A. Dreval and M. Droste and Duarte, \{J. S.\} and T. Dusek and E. Ert{\"u}rk and Evang, \{J. A.\} and C. Fajardo and J. Fazel and Feelders, \{R. A.\} and S. Fica and R. Garc{\'i}a-Centeno and E. Ghigo and M. Goth and Y. Greenman and I. Halperin and Hanzu, \{F. A.\} and A. Hermus and G. Johannsson and E. Hubina and P. Kamenicky and A. Kasperlik-Zaluska and J. Kirchner and D. Kastelan and I. Komerdus and I. Kraljevic and M. Krsek 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 Oliveira, \{M. J.Martins\} and O. Moros and R. Netea-Maier and J. Newell-Price and M. Orbetzova and I. Paiva and Giraldi, \{F. Pecori\} and Percovich, \{J. C.\} and Pereira, \{A. M.\} and M. Pfeiffer and J. Pickel and V. Pirags and O. Ragnarsson and Reghina, \{A. D.\} and Reincke, \{M. A.\} and P. Riesgo and M. Roberts and S. Roerink and C. Rowan and P. Rudenko and Sahnoun, \{M. A.\} and J. Salvador and A. Santos and C. Scaroni and Sigurjonsdottir, \{H. A.\} and Polovina, \{T. Skoric\} and R. Smith and B. Stachowska and G. Stalla and C. Strasburger and A. Tabarin and M. Terzolo and J. T{\H o}ke and M. T{\'o}th and P. Touraine and Trainer, \{P. J.\} and S. Tsagarakis and E. Valassi and G. Vila and S. Vinay and M. Wagenmakers and S. Webb and S. Werner and J. Young and P. Zdunowski and S. Zacharieva and K. Zopf and S. Zopp and I. Zosin",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology.",

year = "2024",

month = jan,

doi = "10.1093/ejendo/lvad176",

language = "English",

volume = "190",

pages = "75--85",

journal = "European Journal of Endocrinology",

issn = "0804-4643",

publisher = "BioScientifica Ltd.",

number = "1",

}

TY - JOUR

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

T2 - data from ERCUSYN and details in relation to surgery

AU - ERCUSYN Study Group

AU - Isand, Kristina

AU - Feelders, Richard

AU - Brue, Thierry

AU - Toth, Miklos

AU - Deutschbein, Timo

AU - Reincke, Martin

AU - Krsek, M.

AU - Santos, A.

AU - Demtröder, Frank

AU - Chabre, O.

AU - Strasburger, C.

AU - Maso, Anna Aulinas

AU - Volke, Vallo

AU - Pereira, A. M.

AU - Lohmann, Rüdiger

AU - Saladich, Ignasi Gich

AU - Webb, Susan M.

AU - Wass, John

AU - Valassi, Elena

AU - Amaral, C.

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 - Thierry, Brue

AU - Cardoso, H.

AU - Carvalho, D.

AU - Cavagnini, F.

AU - Ceccato, P.

AU - Chabre, O.

AU - Chanson, P.

AU - Christ, E.

AU - Demtröder, F. A.

AU - Denes, J.

AU - Deutschbein, T.

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 - Feelders, R. A.

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, G.

AU - Hubina, E.

AU - Kamenicky, P.

AU - Kasperlik-Zaluska, A.

AU - Kirchner, J.

AU - Kastelan, D.

AU - Komerdus, I.

AU - Kraljevic, I.

AU - Krsek, M.

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.Martins

AU - Moros, O.

AU - Netea-Maier, R.

AU - Newell-Price, J.

AU - Orbetzova, M.

AU - Paiva, I.

AU - Giraldi, F. Pecori

AU - Percovich, J. C.

AU - Pereira, A. M.

AU - Pfeiffer, M.

AU - Pickel, J.

AU - Pirags, V.

AU - Ragnarsson, O.

AU - Reghina, A. D.

AU - Reincke, M. A.

AU - Riesgo, P.

AU - Roberts, M.

AU - Roerink, S.

AU - Rowan, C.

AU - Rudenko, P.

AU - Sahnoun, M. A.

AU - Salvador, J.

AU - Santos, A.

AU - Scaroni, C.

AU - Sigurjonsdottir, H. A.

AU - Polovina, T. Skoric

AU - Smith, R.

AU - Stachowska, B.

AU - Stalla, G.

AU - Strasburger, C.

AU - Tabarin, A.

AU - Terzolo, M.

AU - Tőke, J.

AU - Tóth, M.

AU - Touraine, P.

AU - Trainer, P. J.

AU - Tsagarakis, S.

AU - Valassi, E.

AU - Vila, G.

AU - Vinay, S.

AU - Wagenmakers, M.

AU - Webb, S.

AU - Werner, S.

AU - Young, J.

AU - Zdunowski, P.

AU - Zacharieva, S.

AU - Zopf, K.

AU - Zopp, S.

AU - Zosin, I.

PY - 2024/1

Y1 - 2024/1

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 - ERCUSYN

KW - risk factors

KW - venous thromboembolism

UR - https://www.scopus.com/pages/publications/85182016443

U2 - 10.1093/ejendo/lvad176

DO - 10.1093/ejendo/lvad176

M3 - Article

C2 - 38146835

AN - SCOPUS:85182016443

SN - 0804-4643

VL - 190

SP - 75

EP - 85

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

IS - 1

ER -

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

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this