ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Cardiovascular morbidity in acromegaly
Antti Partanen 1 , Elina Peltola 1,2 , Heini Huhtala 3 , Essi Ryödi 4,5 , Heli Rantala 4 , Jarmo Louhelainen 4 , Khalil Sumrein 4,6 , Saara Metso 4,6 , Helene Markkanen 7,8 , Milla Rosengard-Barlund 7 , Henna Cederberg-Tamminen 9 , Elina Ritvonen 7,10 , Satu Vehkavaara 7,10 , Niina Matikainen 7 , Heidi Immonen 11,12 , Pirjo Nuutila 11,12 , Heikki Rajala 13,14 , Leena Moilanen 13,14 , Reeta Rintamäki 13,14 , Minna Koivikko 15,16 , Tapani Ebeling 15,16 , Camilla Schalin-Jantti 7 & Pia Jaatinen 4,6
1Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; 2FImlab Laboratories, Clinical Chemistry, Tampere, Finland; 3Tampere University, Faculty of Social Sciences, Health Sciences, Tampere, Finland; 4Tampere University, Faculty of Medicine and Health Sciences, Tampere, Finland; 5Heart Hospital, Tampere University Hospital Wellbeing Services County of Pirkanmaa, Tampere, Finland; 6Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; 7Helsinki University Hospital, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, ENDO-ERN (European Reference Network on Rare Endocrine Conditions), Helsinki, Finland; 8HUSLAB laboratories, Department of Clinical Chemistry, Helsinki, Finland; 9Turku University Hospital, The wellbeing services county of South-west Finland, Turku, Finland; 10Jorvi Hospital, Hospital District of Helsinki and Uusimaa, Espoo, Finland; 11University of Turku, Faculty of Medicine, Turku, Finland; 12Turku University Hospital, Turku, Finland; 13University of Eastern Finland, Faculty of Medicine, Kuopio, Finland; 14Kuopio University Hospital, Kuopio, Finland; 15University of Oulu, Faculty of Medicine, Oulu, Finland; 16Oulu University Hospital, Oulu, Finland
JOINT1118
Background: Previous research on acromegaly has demonstrated increased morbidity and mortality that are mainly attributable to early cardiovascular diseases (CVD). The aim of our study was to define more comprehensively the risk of CVDs in acromegaly.
Methods: This nation-wide registry study included all Finnish acromegaly patients diagnosed in 1980–2015 at the age of over 16 years. Ten controls matched for age, sex and the area of residence were assigned to each patient. National registries were used to obtain cardiovascular diagnoses given to patients and controls in specialised medical care. CVD-related follow-up started at the acromegaly diagnosis and ended on the date of the CVD of interest, death, or emigration, or the common closing date 31.12.2019. In addition, CVD-related morbidity was analysed for a 10-year period before the acromegaly diagnosis. Clinical data of the acromegaly patients were collected from the Finnish University Hospitals. Morbidity due to different CVDs in patients vs controls was assessed with Kaplan-Meier and Cox regression analyses.
Results: We identified 571 acromegaly patients, of which 565 had sufficient data to be included in the analyses. The incidence of acromegaly was 4.0 [IQR 2.9–4.7] cases/million/year. Mean age at diagnosis was 48.9 (SD 13.3) years. 75% of the tumours were macroadenomas (diameter≥ 10 mm). The median follow-up time was 17.2 [IQR 8.7–26.5] years for the patients and 17.5 [9.4–27.5] years for the controls. Morbidity due to any CVD was found to increase up to 10 years before the acromegaly diagnosis and remained elevated for the whole study period, compared to the controls [HR 2.26 (95% CI 2.04–2.51]. The greatest increase was noted for valvular heart diseases and cardiomyopathies [HR 2.88 (2.24–3.70)], followed by diseases of pulmonary arteries [HR 2.88 (1.96–4.22)] and hypertension [HR 2.30 (2.01–2.64)]. Morbidity was also increased due to arrhythmias [HR 1.77 (1.49–2.11)], heart failure [HR 1.72 (1.35–2.19)], cerebrovascular disease [HR 1.46 (1.16–1.85)], coronary artery disease [HR 1.41(1.16–1.71)] and other diseases of arteries and veins [HR 1.89 (1.60–1.71)].
Conclusion: Acromegaly patients suffered from increased morbidity across all subgroups of CVDs. Morbidity due to any CVD increased years before the acromegaly diagnosis, probably reflecting a long diagnostic delay. We are currently analysing the cardiovascular risk factors and the effect of biochemical control of acromegaly on the cardiovascular prognosis of the patients, to be presented at the meeting.
Volume 110
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