Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Eur J Endocrinol. 2010 May;162(5):879-86. doi: 10.1530/EJE-09-0945. Epub 2010 Feb 9.
Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited.
To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up.
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.
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.
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.
有关肢端肥大症患者冠状动脉疾病（CAD）风险和病程的信息有限。
评估诊断时肢端肥大症患者的 CAD 风险，以及在随访期间成功治疗后的 CAD 风险。
研究了 25 例连续患者（年龄 45.1+/-10.6 岁，15 名女性），在诊断时进行了研究，19 例患者在 4.6+/-1.1 年后进行了重新评估。计算了欧洲心脏病学会（ESC）风险评分，并进行了心脏计算机断层扫描以检测和量化（钙化积分（AS））冠状动脉钙（CACs）。50 名年龄、性别和 CAD 风险匹配的受试者和人群为基础的海因茨·尼克斯多夫召回（HNR）研究的 CAC 数据作为对照。
在 25 例患者中的 21 例中，根据 ESC 风险评分，10 年发生 CAD 的风险较低（<10%），而在 4 例患者中风险较高（>20%）。AS 低于对照组（2.6+/-7.9 对 66+/-182；P=0.014），并且更少的患者存在阳性 CAC（AS>0）（20 对 48%，P=0.024），而在肢端肥大症患者中，这一比例低于 HNR 研究中的预期。AS 与 GH 过多或疾病持续时间无关。在 19 例接受治疗且病情缓解的肢端肥大症患者中，经过 4.6+/-1.1 年重新评估后，ESC 风险（P=0.102）和 AS（P=0.173）没有显著变化，也没有发生症状性 CAD 事件。
新诊断的肢端肥大症患者的 CAD 风险较低，并且在成功治疗后保持稳定。CAC 低于对照组，这表明 GH 过多本身不会带来额外的 CAD 风险。
