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Incidence of Venous Thromboembolism in Patients with Cushing's Syndrome: A Multicenter Cohort Study
Open accessAbstract
CONTEXT: Venous thrombosis has frequently been reported in patients with endogenous Cushing's syndrome (CS). OBJECTIVE: The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) in patients with CS prior to treatment and after surgery. DESIGN AND SETTING: We conducted a multicenter cohort study at all university medical centers in The Netherlands. PATIENTS: Consecutive patients diagnosed with endogenous CS of benign origin between January 1990 and June 2010 were eligible for inclusion. Patients surgically treated for nonfunctioning pituitary adenoma served as controls for the incidence of postoperative VTE in ACTH-dependent CS. MAIN OUTCOME MEASURES: We documented all objectively confirmed VTE during 3 yr prior to, and 3 yr after treatment onset. The incidences of VTE were expressed as incidence rates. RESULTS: A total of 473 patients (mean age 42 yr, 363 women) were included (360 ACTH-dependent pituitary CS). The total number of person-years was 2526. Thirty-seven patients experienced VTE during the study period, resulting in an incidence rate of 14.6 [95% confidence interval (CI) 10.3-20.1] per 1000 person-years. The incidence rate for first-ever VTE prior to treatment was 12.9 (95% CI 7.5-12.6) per 1000 person-years (17 events). The risk of postoperative VTE, defined as risk within 3 months after surgery, was 0% for ACTH-independent and 3.4% (95% CI 2.0-5.9) for ACTH-dependent CS (12 events in 350 patients); most events occurred between 1 wk and 2 months after surgery. Compared with the controls, the risk of postoperative VTE in patients undergoing transsphenoidal surgery was significantly greater (P = 0.01). CONCLUSIONS: Patients with CS are at high risk of VTE, especially during active disease and after pituitary surgery. Guidelines on thromboprophylaxis are urgently needed.
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“Finally, patients with active CS have a high risk of venous thromboembolism (VTE) in comparison to the general population (8, 45, 46).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [46]
In the citing paper
“Cushing syndrome is associated with a high risk of venous thromboembolic events which can be a presenting symptom”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [46]
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Self-citation
Metadata
- Authors
- Stuijver, D. J. F., van Zaane, B., Feelders, R. A., Debeij, J., Cannegieter, S. C., Hermus, A. R., van den Berg, G., Pereira, A. M., de Herder, W. W., Wagenmakers, M. A. E. M., Kerstens, M. N., Zelissen, P. M. J., Fliers, E., Schaper, N., Drent, M. L., Dekkers, O. M., & Gerdes, V. E. A.
- Affiliations
- Slotervaartziekenhuis (NL)
- Erasmus MC (NL)
- Leiden University Medical Center (NL)
- Radboud University Nijmegen (NL)
- University Medical Center Groningen (NL)
- University Medical Center Utrecht (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Maastricht University Medical Centre (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Stuijver, D. J. F.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-11
- Volume
- 96
- Issue
- 11
- Pages
- 3525-3532
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2005854940
- Cited by
- 208
- References
- 45
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 14 · 2023: 16 · 2022: 23 · 2021: 18 · 2020: 8 · 2019: 7 · 2018: 14 · 2017: 8 · 2016: 12 · 2015: 19 · 2014: 11 · 2013: 11 · 2012: 20
- FWCI
- 11.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- VU Research Portal (submittedVersion)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Clinical Neurology › Cerebral Venous Sinus Thrombosis
- Keywords
- Cushing's syndrome, venous thromboembolism, incidence, ACTH-dependent Cushing's syndrome, ACTH-independent Cushing's syndrome, pituitary adenoma, transsphenoidal surgery, postoperative thrombosis, thromboprophylaxis, hypercortisolism
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cushing Syndrome, Female, Humans, Male, Middle Aged, Netherlands, Postoperative Complications, Postoperative Period, Cohort Studies, Incidence, Venous Thromboembolism
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