Abstract 16580: Cardiovascular Disease in Cushing Syndrome, Conns Syndrome and Malignant Pheochromocytoma: Which Adrenal Disorder is Associated With Thromboembolism and Cardiac Tumors?
Bilal Hussain, Ahmed M Mahmood, Luay Alalawi, christel cuevas, Sohail Khan, Fahad Waqar, Mohammad M Ansari, Thomas Alexander- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Adrenal disorders result in worse cardiovascular outcomes. Literature suggests that Cushing (CUSH) and Conn’s syndrome (CONS) are associated with coronary artery disease, congestive heart failure (CHF), arrhythmia and stroke. But the date comparing the association of various adrenal disorders with cardiovascular disease (CVD) is limited. We reviewed the prevalence of CVD in CUSH, CONS, and malignant pheochromocytoma (MPH) and explored their prognosis.
Methods: A retrospective cohort analysis was conducted using National Inpatient Sample 2016-2020. Cohorts of patients hospitalized for CUSH, CONS, MPH and CVD were identified using respective ICD-10 codes. Primary endpoint was outcomes of CUSH, CONS, and MPH in terms of CVD. Multivariate logistic regression model was used to assess prognostic outcomes.
Results: 58060 patients were admitted with CUSH, 3420 with CONS, and 1445 with MPH. CONS has the highest odds of association with CVD (OR 4.87, CI 3.74-6.3, p<0.001), followed by CUSH (OR 3.45, CI 3.3-3.6, <0.001), and MPH (OR 3, CI 2.1-4.3, p<0.001). Upon subgroup analysis of CVD, we observed that CUSH has strongest association with venous thromboembolism (VTE, OR 2.56, CI 2.3-2.8, p<0.001), pulmonary embolism (PE 2.3, OR 2.03-2.6, p<0.001), and CHF (OR 2.2, CI 2.1-2.3, p<0.001). CONS has highest odds of association with primary cardiac tumors (9.2, CI 1.29-65.3, p=0.027), hypertension (HTN, OR 2.8, CI 2.34-3.3, p<0.001), and atrial fibrillation (AF, OR 1.66, CI 1.32-2.06, p<0.001). While MPH is strongly associated with higher odds of pulmonary edema (OR 3.89, CI 1.71-8.8, p<0.01), and HTN (OR 2.8, CI 2.1-3.6, p<0.001).
Conclusion: Most prevalent CVD in adrenal disorders are HTN, IHD, CHF, and AF. CONS has highest prevalence and strongest association with CVD followed by CUSH and MPH. CUSH is strongly associated with thromboembolism while CONS with primary cardiac tumors, and MPH with pulmonary edema.