Acromegaly and cardiovascular outcomes: a cohort study
- Authors
- Hong, Sangmo; Kim, Kyung-Soo; Han, Kyungdo; Park, Cheol-Young
- Issue Date
- Apr-2022
- Publisher
- OXFORD UNIV PRESS
- Keywords
- Acromegaly; Atrial fibrillation; Congestive heart failure; Mortality; Myocardial infarction; Stroke
- Citation
- EUROPEAN HEART JOURNAL, v.43, no.15, pp.1491 - 1499
- Journal Title
- EUROPEAN HEART JOURNAL
- Volume
- 43
- Number
- 15
- Start Page
- 1491
- End Page
- 1499
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/43492
- DOI
- 10.1093/eurheartj/ehab822
- ISSN
- 0195-668X
- Abstract
- Aims Cardiovascular disease is a common complication in acromegaly. We investigated the risk of cardiovascular disease and mortality in patients with acromegaly in a large-scale population using nationwide data in Korea. Methods and results We performed a nationwide, retrospective, observational, cohort study of patients with acromegaly (n = 1874) and age- and sex-matched subjects without acromegaly (n = 9370) for a mean follow-up of 7.5 +/- 3.2 years. The study outcomes were myocardial infarction, stroke, atrial fibrillation, congestive heart failure, and all-cause death. All outcomes were analysed by Cox proportional hazards regression analysis while controlling for age, sex, household income, place, Type 2 diabetes, hypertension, and dyslipidaemia. The incidence (per 1000 person-years) of atrial fibrillation (3.06 vs. 1.70; P = 0.001), congestive heart failure (3.11 vs. 1.63; P < 0.001), and all-cause mortality (6.31 vs. 4.03; P < 0.001) in patients with acromegaly was higher than in controls. However, the incidence of myocardial infarction and stroke did not differ between groups. After adjustment for covariates, the risk for atrial fibrillation [hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.09-2.31], congestive heart failure (HR: 1.54; 95% CI: 1.06-2.25), and all-cause mortality (HR: 1.31; 95% CI: 1.01-1.69) was significantly higher in patients with acromegaly. In time lag sensitivity analysis, a higher risk for atrial fibrillation was observed only in the first 4 years after diagnosis in acromegaly patients compared with controls (HR: 3.05; 95% CI: 1.94-4.79). Conclusion Patients with acromegaly were at higher risk for atrial fibrillation, congestive heart failure, and all-cause death. The risk of atrial fibrillation had a time-dependent association with acromegaly.
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