Prevalence of coronary calcium deposits in Sheehan’s syndrome patients on long term replacement treatment

High prevalence of coronary artery calcification and increased risk for coronary artery disease in patients with Sheehan syndrome—A case–control study

“…Present study revealed that 12.5% of patients with SS had LAD and LCX involvement, whereas 9.4% had involvement of LMCA and none had involvement of RCA and PDA. The non‐involvement of RCA and PDA is reported in a previous investigation 10 . In general, several arteries were more frequently involved than single artery.…”

“…However, 31.5% hypopituitary patients in above study had CAC score >10, classified as at risk for CAD, which is comparable with current study. In a recent study by Singh et al, 10 16.67% of women with SS were classified as intermediate risk for CAD after calculating FRS. While studying coronary calcium,31.6% of women had CAC score > 10.…”

“…Despite treatment for hypogonadism, secondary hypothyroidism and cortisol deficiency, these hypopituitary patients have insulin resistance (IR), lipid abnormalities, low‐grade inflammation and endothelial dysfunction 6–9 . Low insulin‐like growth factor‐1 (IGF‐1), hypogonadism, poorly controlled secondary hypothyroidism and glucocorticoid overuse may predispose these women to CAD 10–15 …”

“…CAC risk scoring is more sensitive than FRS for the detection of asymptomatic CAD and predicts CV events independently 19 . Hypopituitary patients have an increased risk of future CV events based on FRS and CAC scores and the severity of CAC is related to serum IGF‐1 levels 10,11 . However, data on the probability of CV events in SS is limited to a single study, which enroled small number of patients, and detected CAC in 42% patients compared to 5.3% healthy controls 10 .…”

“…[6][7][8][9] Low insulin-like growth factor-1 (IGF-1), hypogonadism, poorly controlled secondary hypothyroidism and glucocorticoid overuse may predispose these women to CAD. [10][11][12][13][14][15] Detecting asymptomatic CAD and predicting future cardiovascular (CV) events in general population can be obtained by risk stratifying subjects using either Framingham risk score (FRS) or estimating coronary artery calcification (CAC) score. FRS is a simple clinical tool (based on conventional risk factors like age, smoking, systolic blood pressure, total cholesterol [TC] and high-density lipoprotein cholesterol [HDL-C]) that estimates the 10-year risk of CV events.…”