Cushing syndrome of different etiologies - cardiometabolic complications, venous thromboembolic events and mortality: data from ERCUSYN Krakow database

TL;DR

This study examines the health complications and mortality in patients with Cushing syndrome of different causes, using data from a Polish endocrinology center.

Contribution

The study provides insights into the cardiometabolic and mortality differences among Cushing syndrome subtypes in a Polish cohort.

Findings

ECT-CS patients had the highest mortality rate (62%) and more heart-related conditions.

Males had higher mortality (30%) compared to females (15%).

Tumor progression was the leading cause of death in Cushing syndrome patients.

Abstract

Cushing syndrome (CS) as a state of prolonged cortisol excess is associated with multiple complications that contribute to increased mortality in affected patients.

This retrospective study presents data on etiology, demographic features, baseline cardiometabolic comorbidities, venous thromboembolic events and mortality of 214 consecutive CS patients from a single tertiary endocrinology center in Poland, a part of the European Register on Cushing’s Syndrome (ERCUSYN). The group was predominated by pituitary CS (53%, PIT-CS), followed by adrenal CS (25%, ADR-CS) and ectopic CS (22%, ECT-CS). Statistica 13.0 was used to perform data analysis. Statistical significance was settled for a p-value ≤0.05.

The PIT-CS group was significantly younger than others. The PIT-CS and ADR-CS groups were predominated by women, contrary to the ECT-CS group, predominated by men. At the baseline, respectively 80%, 78%, and 66% of patients presented hypertension, dyslipidemia, and glucose metabolism impairments. Ischemic heart disease and heart failure were significantly more prevalent among ECT-CS. Venous thromboembolic events were present among 6% of patients. Overall mortality rate was 18%, and was higher in males than females (30% vs 15%; p<0.05), and was the highest in ECT-CS group (62%). The most common cause of death was tumor progression (55%) and infectious disease (26%).

CS patients from our study presented a high number of comorbidities and high mortality rate. Some of the results were convergent with reports of the entire ERCUSYN database and other studies, while other results differed from the data reported in the literature.

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