Acromegaly was associated with a significantly higher risk of atrial fibrillation (HR 1.59; 95% CI 1.09-2.31), congestive heart failure, and all-cause mortality compared to matched controls.
Cohort (n=11,244)
Yes
Does acromegaly increase the risk of cardiovascular disease and mortality compared to matched controls?
Acromegaly is independently associated with a significantly higher risk of incident atrial fibrillation, congestive heart failure, and all-cause mortality.
Effect estimate: HR 1.59 (95% CI 1.09-2.31)
Absolute Event Rate: 3.06% vs 1.7%
p-value: p=0.001
AIMS: Cardiovascular disease is a common complication in acromegaly. We investigated the risk of cardiovascular disease and mortality in patients with acromegaly in a large-scale population using nationwide data in Korea. METHODS AND RESULTS: We performed a nationwide, retrospective, observational, cohort study of patients with acromegaly (n = 1874) and age- and sex-matched subjects without acromegaly (n = 9370) for a mean follow-up of 7.5 ± 3.2 years. The study outcomes were myocardial infarction, stroke, atrial fibrillation, congestive heart failure, and all-cause death. All outcomes were analysed by Cox proportional hazards regression analysis while controlling for age, sex, household income, place, Type 2 diabetes, hypertension, and dyslipidaemia. The incidence (per 1000 person-years) of atrial fibrillation (3.06 vs. 1.70; P = 0.001), congestive heart failure (3.11 vs. 1.63; P < 0.001), and all-cause mortality (6.31 vs. 4.03; P < 0.001) in patients with acromegaly was higher than in controls. However, the incidence of myocardial infarction and stroke did not differ between groups. After adjustment for covariates, the risk for atrial fibrillation hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.09-2.31, congestive heart failure (HR: 1.54; 95% CI: 1.06-2.25), and all-cause mortality (HR: 1.31; 95% CI: 1.01-1.69) was significantly higher in patients with acromegaly. In time lag sensitivity analysis, a higher risk for atrial fibrillation was observed only in the first 4 years after diagnosis in acromegaly patients compared with controls (HR: 3.05; 95% CI: 1.94-4.79). CONCLUSION: Patients with acromegaly were at higher risk for atrial fibrillation, congestive heart failure, and all-cause death. The risk of atrial fibrillation had a time-dependent association with acromegaly.
Hong et al. (Thu,) conducted a cohort in Acromegaly (n=11,244). Acromegaly vs. Matched subjects without acromegaly was evaluated on Atrial fibrillation (HR 1.59, 95% CI 1.09-2.31, p=0.001). Acromegaly was associated with a significantly higher risk of atrial fibrillation (HR 1.59; 95% CI 1.09-2.31), congestive heart failure, and all-cause mortality compared to matched controls.