Risk of blood clots higher in years after Cushing’s diagnosis: Study
5 times higher risk of dangerous blood clots in 5 years following diagnosis
People with Cushing’s syndrome are at an increased risk of experiencing dangerous blood clotting events in the years following diagnosis, according to a recent study.
These data underscore “the critical need for heightened vigilance and targeted management strategies in this high-risk population,” researchers wrote.
The study, “Can we predict the risk of venous thromboembolism in patients with Cushing’s syndrome: a nationwide cohort analysis,” was published in Pituitary.
Cushing’s syndrome is a broad term encompassing health problems that are caused by excessively high levels of the hormone cortisol in the body. Cushing’s disease is a specific form of the syndrome where cortisol levels are increased as a result of a tumor in the brain’s pituitary gland.
Venous thromboembolism can cause life-threatening problems
Venous thromboembolism, or VTE, occurs when blood clots form inside veins, blocking blood flow, and potentially causing serious and even life-threatening problems. Prior studies have shown that people with Cushing’s are at an increased risk of experiencing VTEs. However, these studies have mainly focused on the period around the time patients had surgery to remove disease-causing tumors.
“Our research underscores that the increased risk of VTE in [Cushing’s] patients extends beyond the perioperative period,” the scientists wrote.
In this study, the team analyzed data from an Israeli healthcare database to more holistically evaluate the risk of VTEs in Cushing’s patients in the years following diagnosis.
The analysis included data from more than 600 people living with Cushing’s disease or other forms of Cushing’s syndrome, as well as data from more than 3,000 people who did not have Cushing’s but were similar in terms of age, sex, socioeconomic status, and other factors.
Results showed, in the five years after diagnosis, 2.6% of Cushing’s patients experienced a VTE, compared with 0.56% of people without Cushing’s. Mathematically, that works out to a roughly fivefold increase in VTE risk for Cushing’s patients.
Additional analyses showed the risk of VTEs was elevated in people with Cushing’s disease, as well as in those with other forms of Cushing’s syndrome.
Cushing’s patients at increased risk of blood clots in lungs, legs
Data also indicated Cushing’s patients were at an increased risk of having both a pulmonary embolism — a type of VTE that occurs when a blood clot blocks blood vessels in the lungs — and deep vein thrombosis, a type of VTE where clots form in deep veins, usually in the legs.
Analyses taking into account the total follow-up period, which was more than a decade for most patients, likewise showed an increased risk of VTEs in people with Cushing’s syndrome. After a median follow-up of nearly 15 years, VTE rates were roughly twice as high in Cushing’s patients (4.9% vs. 2.5%).
Mathematical models suggested that, among Cushing’s patients, the risk of VTE was especially elevated in patients who were 60 or older at the time of diagnosis, or had heart or kidney disease, high blood pressure, or a history of VTEs before being diagnosed with Cushing’s.
Given the increased risk of VTEs in Cushing’s patients, the researchers called for more studies to test anti-clotting treatment regimens that can help minimize that risk.
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