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Incidence of myocardial infarction and stroke in acromegaly patients: results from the German Acromegaly Registry

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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

  1. 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.

Author information

Authors and Affiliations

  1. Centre of Endocrinology and Metabolism, Obstmarkt 1, 96047, Bamberg, Germany

    Christof Schöfl

  2. Clinical Trial Centre, University of Leipzig, Leipzig, Germany

    David Petroff

  3. Division of Endocrinology and Nephrology, Medical Department, University of Leipzig, Leipzig, Germany

    Anke Tönjes

  4. Centre of Endocrinology and Diabetes, Stuttgart, Germany

    Martin Grussendorf

  5. Endocrine Practice, Oldenburg, Germany

    Michael Droste

  6. Max Planck Institute of Psychiatry, Munich, Germany

    Günter Stalla

  7. Department of Endocrinology, German Clinic of Diagnostics, Wiesbaden, Germany

    Cornelia Jaursch-Hancke

  8. Medizinische Klinik IV, Ludwig-Maximilians-University Munich, Munich, Germany

    Sylvère Störmann & Jochen Schopohl

Authors
  1. Christof Schöfl
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  2. David Petroff
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  4. Martin Grussendorf
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  7. Cornelia Jaursch-Hancke
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  9. Jochen Schopohl
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Corresponding author

Correspondence to Christof Schöfl.

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Conflict of interest

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.

Ethical approval

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

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