Blood coagulation and fibrinolysis in patients with acromegaly: increased plasminogen activator inhibitor-1 (PAI-1), decreased tissue factor pathway inhibitor (TFPI), and an inverse correlation between growth hormone and TFPI

Erem, Cihangir; Nuhoğlu, İrfan; Koçak, Mustafa; Yılmaz, Mustafa; Sipahi, Safiye Tuba; Ucuncu, Ozge; Ersöz, Halil Önder

doi:10.1007/s12020-008-9088-4

Cited by 27 publications

(50 citation statements)

References 53 publications

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“…GH excess also has been linked to the development of hypercoagulation and venous thrombosis (35). In accordance with this, we recorded a slightly increased risk of VTE in our study.…”

Section: Discussionsupporting

confidence: 91%

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Dal

Feldt‐Rasmussen

Andersen

et al. 2016

European Journal of Endocrinology

173

125

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Design: Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study. Method: All incident cases of acromegaly in Denmark (1991Denmark ( -2010 were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10 6 person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used. Results: Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10 6 persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10 6 persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality. Conclusion: (i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported.(ii) The risk of complications is very high even before the diagnosis.(iii) Mortality risk remains elevated but uninfluenced by mode of treatment.

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“…GH excess also has been linked to the development of hypercoagulation and venous thrombosis (35). In accordance with this, we recorded a slightly increased risk of VTE in our study.…”

Section: Discussionsupporting

confidence: 91%

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Dal

Feldt‐Rasmussen

Andersen

et al. 2016

European Journal of Endocrinology

173

125

View full text Add to dashboard Cite

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“…Several prospective studies have consistently shown that a direct, independent, and statistically significant association exists between fibrinogen levels and subsequent incidence of heart disease [6,8,19]. Increased fibrinogen levels have been reported in patients with acromegaly [6][7][8]20]. Similarly, in our study we observed increased fibrinogen levels in acromegalic patients.…”

Section: Discussionsupporting

confidence: 87%

“…Cardiovascular and cerebrovascular events are the primary cause of death in acromegaly [6,15]. The increase in mortality may be attributed to the increased prevalence of hypertension, insulin resistance, dyslipidemia, hypertrophic cardiomyopathy, and endothelial dysfunction in patients with acromegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrinogen is a coagulation factor involved in thrombus formation. Several prospective studies have consistently shown that a direct, independent, and statistically significant association exists between fibrinogen levels and subsequent incidence of heart disease [6,8,19]. Increased fibrinogen levels have been reported in patients with acromegaly [6][7][8]20].…”

Section: Discussionmentioning

confidence: 99%

“…The reported prevalence of coronary artery disease in acromegalic patients ranges from 3 to 37 % in different studies [1,5]. There are several studies about coagulation and fibrinolysis in acromegalic patients as possible risk factors for cardiovascular disease [6][7][8][9]. Also, the effect of growth hormone (GH) on coagulation parameters has been previously studied [1,[7][8][9] but there are only two studies which evaluate protein C and S activities in patients with acromegaly [1,6].…”

mentioning

confidence: 99%

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Coagulation parameters and platelet function analysis in patients with acromegaly

Çolak

Yilmaz

Temel

et al. 2015

J Endocrinol Invest

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Unexplained massive pulmonary embolism in acromegaly patient: A case report

Al‐Anbagi,

Usman,

Saad

et al. 2024

Clinical Case Reports

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Key Clinical MessageOur case highlights the importance of recognizing acromegaly as a potential risk factor for venous thromboembolism (VTE). Despite a thorough thrombophilia workup yielding unremarkable results, further research is warranted to elucidate the underlying mechanisms linking acromegaly and thrombophilia. This understanding will aid in improving risk assessment and management strategies for patients with acromegaly.AbstractAcromegaly, a rare disorder characterized by excessive growth hormone secretion, is associated with various comorbidities including hypertension, diabetes mellitus, and obstructive sleep apnea. While previous studies have identified abnormalities in hemostatic factors in acromegaly patients, the association between acromegaly and venous thromboembolism (VTE) remains poorly understood. We present the case of a 36‐year‐old male with a history of acromegaly who presented with acute dyspnea, chest pain, and cough. Despite a prior trans‐sphenoidal hypophysectomy, his acromegaly symptoms persisted. Upon evaluation, he was found to have bilateral pulmonary embolism. Thorough thrombophilia workup was unremarkable, suggesting acromegaly as a potential risk factor for VTE.

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Blood coagulation and fibrinolysis in patients with acromegaly: increased plasminogen activator inhibitor-1 (PAI-1), decreased tissue factor pathway inhibitor (TFPI), and an inverse correlation between growth hormone and TFPI

Cited by 27 publications

References 53 publications

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Coagulation parameters and platelet function analysis in patients with acromegaly

Unexplained massive pulmonary embolism in acromegaly patient: A case report

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