High prevalence of coronary artery calcification and increased risk for coronary artery disease in patients with Sheehan syndrome—A case–control study

• Published in: Clinical endocrinology (Oxford) 2023-03, Vol.98 (3), p.375-382
• Main Authors: Laway, Bashir Ahmad, Rasool, Abid, Baba, Mohammad Salem, Misgar, Raiz Ahmad, Bashir, Mir Iftikhar, Wani, Arshad Iqbal, Choh, Naseer, Shah, Omair, Lone, Ajaz, Shah, Zaffar
• Format: Article
• Language: English
• Subjects: agatston score; Apolipoprotein B; Arteriosclerosis; Body mass index; C-reactive protein; C-Reactive Protein - metabolism; Calcification (ectopic); Calcium; Cardiovascular disease; Case-Control Studies; Computed tomography; coronary artery calcium; Coronary artery disease; Coronary Artery Disease - etiology; Coronary Artery Disease - metabolism; Coronary Vessels; Dyslipidemia; Framingham score; Growth hormones; Heart diseases; Humans; Hypopituitarism - complications; panhypopituitarism; Prevalence; Risk Factors; Sheehan syndrome; Vascular Calcification - etiology; Vascular Calcification - metabolism; Vein & artery diseases
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.14871

Objective Patients with Sheehan syndrome (SS) are predisposed to coronary artery disease (CAD) due to risk factors like abdominal obesity, dyslipidemia and chronic inflammation. In addition to estimate CAD risk enhancers like high sensitive C reactive protein (hsCRP), apolipoprotein B (ApoB) and lipoprotein A [Lp(a)], this study applies Framingham risk score (FRS) and coronary artery calcium (CAC) score to compute a 10‐year probability of cardiovascular (CV) events in SS patients. Design Case–control study Sixty‐three SS patients, on a stable hormonal replacement treatment except for growth hormone and 65 age, body mass index and parity‐matched controls. Measurements Measurement of serum hsCRP, ApoB and Lp(a) and estimation of CAC with 16‐row multislice computed tomography scanner. Results The concentrations of hsCRP, ApoB and Lp(a) were significantly higher in SS patients than in controls (p  10) for incident CV events as against 1.6% controls. The mean Multi‐Ethnic Study of Atherosclerosis (MESA) score was significantly higher in patients with SS than controls. CAC corelated significantly with fasting blood glucose (r = .316), ApoB (r = .549), LP(a) (r = .310) and FRS (r = .294). Conclusion Significant number of asymptomatic SS patients have high coronary artery calcium score and are classified at risk for CAD.