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No increase in MI, stroke incidence in acromegaly

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August 22, 2017

The incidence of myocardial infarction and stroke among patients with acromegaly is similar to that of the general population, and researchers observed no relationship between stroke and radiation therapy, according to findings published in Pituitary.

“In all, the data on cardio- and cerebrovascular events in acromegaly are limited, controversial, mainly refer to older pathological studies or are based on mixed patient populations comprising controlled and uncontrolled acromegaly,” Christof Schofl, MD, PhD, of the Center of Endocrinology and Metabolism in Bamberg, Germany, and colleagues wrote. “Hence, we decided to study the incidence of MIs and strokes along with the connection to radiation therapy in a well-controlled, representative and large cohort of patients.”

Schofl and colleagues analyzed data from 479 patients in the German Acromegaly Registry in seven specialized endocrine centers (56% women; mean age, 46 years). Researchers obtained data on CV events through interviews or medical record review; they calculated standardized incidence ratios (SIRs) by dividing the number of observed events by the number of expected events when compared with general population. All incidents of MI and stroke up to 8 years before diagnosis were included in analyses, based on the estimates suggesting that onset of disease is about 8 years before diagnosis, on average.

During a mean of 11.6 years, researchers observed 13 MIs in 12 patients, occurring 10 years after diagnosis on average, and 15 strokes in 15 patients, occurring 14 years after diagnosis on average.

Researchers observed an SIR of 0.89 for MI (95% CI, 0.47-1.52) and an SIR of 1.17 for stroke (95% CI, 0.66-1.93). Among patients who experienced an MI or stroke, 80% had undergone an acromegaly procedure and 40% were on medication vs. 93.2% and 46.2%, respectively, who did not experience MI or stroke. More patients experiencing MI or stroke had high blood pressure (94.1% vs. 43.4%; P < .001). Researchers did not observe an association between radiation therapy and stroke. – by Regina Schaffer

Disclosures:The German Acromegaly Registry is supported by unrestricted grants from Ipsen, Novartis and Pfizer. Schofl and two other authors report receiving lecture fees or serving on advisory boards for Ipsen, Novartis and Pfizer.