Abstract
Purpose
Acromegaly is a rare disease generally brought about by a benign tumour in the pituitary and characterized by growth hormone (GH) and insulin-like growth factor 1 (IGF-1) excess. Increased mortality has been related to cardiovascular events that could be linked to these hormones and patients suffer from high rates of diabetes and hypertension. In this study, we examine if the incidence of myocardial infarction (MI) and stroke differ from that of the general population.
Methods
Data from the German Acromegaly Registry in seven specialized endocrine centres were analysed (n = 479, 56% female, 46 years old at diagnosis, 5549 person-years from diagnosis). Standardized incidence ratios (SIR) were calculated as compared to the general population.
Results
MI and stroke incidences were very close to those of the general population with an SIR (95% CI) of 0.89 (0.47–1.52, p = 0.80) for MI and 1.17 (0.66–1.93, p = 0.61) for stroke. Acromegaly was uncontrolled in 16% of patients with MI or stroke versus 21% in those without (p = 0.56). Prevalence of hypertension at the initial visit was much higher in those with MI or stroke than those without (94 vs. 43%, p < 0.001). No association was seen between radiation therapy and stroke.
Conclusions
For acromegaly patients being treated at specialized centres, the incidence of MIs and strokes does not seem to differ from the general population. Certainty regarding such statements requires large, prospective studies however.


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Notes
The stroke status of one patient who received radiation therapy and had a MI is unknown. This leads tot he discrepancy between the 103 radiation patients analysed and the 104 presented in Table 1.
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Funding
The German Acromegaly Register is supported by unrestricted grants from Novartis Pharma GmbH, Nuremberg, Germany; Ipsen Pharma GmbH, Ettlingen, Germany; and Pfizer Deutschland GmbH, Berlin, Germany.
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CS has received lecture fees from Novartis, Ipsen and Pfizer and has served on advisory boards of Novartis and Pfizer. GS has served on advisory boards of Ipsen, Novartis and Pfizer. SS has received lecture fees from Novartis and Pfizer and has served on advisory boards of Novartis. JS has received lecture fees from Novartis, Ipsen and Pfizer and has served on advisory boards of Novartis and Ipsen.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol for the data registry was approved by the Ethics Committee of the Charité-Universitätsmedizin Berlin, Germany, and by the Berlin commissioner for data protection and freedom of information.
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Schöfl, C., Petroff, D., Tönjes, A. et al. Incidence of myocardial infarction and stroke in acromegaly patients: results from the German Acromegaly Registry. Pituitary 20, 635–642 (2017). https://doi.org/10.1007/s11102-017-0827-5
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DOI: https://doi.org/10.1007/s11102-017-0827-5