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Steroids increased risk for CVD, mortality in patients with Cushing’s disease
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It has been established in the literature that Cushing’s disease is associated with an increased risk for mortality. In a recent study, researchers suggest that even after successful treatment, patients exposed to excessive amounts of cortisol have a greater risk for dying or developing cardiovascular disease.
“The longer patients with Cushing’s disease are exposed to excess cortisol and the older they are when diagnosed, the more likely they are to experience these challenges,” study researcher Eliza B. Geer, MD, of Mount Sinai Medical Center, said in a press release. “The findings demonstrate just how critical it is for Cushing’s disease to be diagnosed and treated quickly. Patients also need long-term follow-up care to help them achieve good outcomes.”
Based on their response to initial treatment, 346 patients (mean age, 39.9 years) were categorized into one of three outcomes: immediate remission, late remission or persistent disease. Their exposure to excess glucocorticoids was 40 months, and the mean duration of the study follow-up was 6.3 years, researchers wrote.
According to data, the duration of glucocorticoid exposure tended to elevate the risk for death (P=.038), as well as older age at diagnosis (P=.0001) and preoperative adrenocorticotropic hormone concentration (P=.007). Researchers reported that depression increased the risk for death (P<.01) among patients who experienced remission.
Further data indicate that men (n=81) were at greater risk for CVD compared with women (n=265) and those with diabetes and depression (P<.05).
“While steroid medicals are useful for treating patients with a variety of conditions, the data suggest health care providers need to be aware that older patients or those who take steroid medications for long periods could be facing higher risk,” Geer said in the release. “These patients should be monitored carefully while more study is done in this area.”
Disclosure: The researchers report no relevant financial disclosures.
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