Acromegaly per se does not increase the risk for coronary artery disease

Abstract

Context: Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited. Objective: To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up. Subjects and methods: 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. Results: 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. Conclusion: 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. © 2010 European Society of Endocrinology.