Cited by 210Venous Thromboembolism Diagnosis and ManagementPituitary Gland Disorders and TreatmentsCerebral Venous Sinus Thrombosis

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Incidence of Venous Thromboembolism in Patients with Cushing's Syndrome: A Multicenter Cohort Study

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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.·2011·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2011-1661

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Abstract

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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Additional file 2 of The genetic effects of hormones modulated by the Pituitary-Thyroid/Adrenal/Gonadal axis on the risk of developing venous thromboembolism: a mendelian randomization study
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Additional file 1 of The genetic effects of hormones modulated by the Pituitary-Thyroid/Adrenal/Gonadal axis on the risk of developing venous thromboembolism: a mendelian randomization study
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Additional file 3 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)
van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19703742
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Additional file 1 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)
van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19703736
Self-citation
Additional file 4 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)
van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19703745
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Additional file 5 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)
van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19703748
Self-citation
Pituitary surgery for Cushing's Disease
Jones, P. M., & Swearingen, B. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00353-8

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: 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.
Fliers, E.
Schaper, N.
Drent, M. L.
Dekkers, O. M.
Gerdes, V. E. A.
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
DOI: 10.1210/jc.2011-1661
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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Incidence of Venous Thromboembolism in Patients with Cushing's Syndrome: A Multicenter Cohort Study

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