ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)
Adrenalectomy ameliorates cardiovascular profile in patients with mild autonomous cortisol secretion: results of a RCT
Valentina Morelli 1 , Maria Strata 2 , Serena Palmieri 2 , Carmen Aresta 3 , Vittoria Favero 4 , Sofia Frigerio 2 , Flavia Pugliese 5 , Antonio Musolino 4 , Alberta Dall’Antonia 4,6,6 , Sabrina Corbetta 4 , Maura Arosio 4 , Alfredo Scillitani 5 & Iacopo Chiodini 3,4
1Istituto Auxologico Italiano IRCCS, Milan, Italy; 2Fondazione IRCCS Cà Granda, Milan, Italy; 3Ospedale Niguarda, Unit of Endocrinology, Milan, Italy; 4University of Milan, Milan, Italy; 5Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo (FG), Italy; 6Milan, Milan, Italy
JOINT1535
Context: The best therapeutic approach in patients with mild autonomous cortisol secretion (MACS) is debated.
Objective: To evaluate the effect of adrenalectomy on blood pressure (BP), glycometabolic control, cardiac structure and coagulation factors in patients with MACS.
Design: Prospective randomized controlled trial.
Setting: Outpatients.
Patients: Patients with adrenal incidentaloma (AI) >1 cm and cortisol after 1 mg dexamethasone suppression test (F-1 mgDST) between 1.8 (50 nmol/l) and 5 μg/dL (138 nmol/l).
Intervention: Randomization to adrenalectomy (Arm-A) or conservative approach (Arm-B).
Main outcomes measure: BP, coagulation factors, echocardiography and glycemic control, parameters and medical therapy changes assessed at baseline and 12 months after recovery or observation, in Arm-A and Arm-B, respectively.
Results: Fifty-one subjects (23/28 in Arm-A/Arm-B) were enrolled. At follow-up the prevalence of BP improvement was higher in Arm-A (43.5%) than in Arm-B patients (14.3%, P=0.020). The improvement of BP control was 5.4-fold more frequent in Arm-A patients (CI, 1.16–24.9 P=0.031), regardless of confounding factors. Left ventricular (LV) mass and Left atrial (LA) area decreased at follow-up in Arm-A (96.4±28.8 vs 87.6±25, 6 g/m2, P=0.039; 28.4±9.9 vs 22.6±12.4 cm2, P=0.037, respectively), whereas they remained stable in Arm-B. At the end of follow-up, Arm-A patients had a lower prevalence of altered anti-coagulant parameters (10% vs 50%, respectively, P=0.005). The improvement of ≥1 out of hypertension, LV hypertrophy or LA dilatation and coagulation state was observed in 82.5% of patients of Arm-A and in 49.1% of Arm-B group (P=0.015)
Conclusion: In patients with MACS surgery ameliorates BP, cardiac structure, and coagulation factors
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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