Antiplatelet and anticoagulation therapy and the risk of pituitary apoplexy in pituitary adenoma patients

• Published in: Pituitary 2023-08, Vol.26 (4), p.375-382
• Main Authors: Ciavarra, Bronson, McIntyre, Timothy, Kole, Matthew J., Li, Wen, Yao, William, Guttenberg, Katie B., Blackburn, Spiros L.
• Format: Article
• Language: English
• Subjects: Adenoma; Adenoma - surgery; Anticoagulants - adverse effects; Aspirin; Brain tumors; Clopidogrel; Clopidogrel - therapeutic use; Endocrinology; Hemorrhage; Hormones; Human Physiology; Humans; Male; Medicine; Medicine & Public Health; Patients; Pituitary; Pituitary Apoplexy - drug therapy; Pituitary Apoplexy - etiology; Pituitary Neoplasms - surgery; Retrospective Studies; Risk factors; Stroke; Tumors
• ISSN: 1386-341X; 1573-7403
• DOI: 10.1007/s11102-023-01316-5

Purpose Pituitary apoplexy can be a life threatening and vision compromising event. Antiplatelet and anticoagulation use has been reported as a contributing factor in pituitary apoplexy (PA). Utilizing one of the largest cohorts in the literature, this study aims to determine the risk of PA in patients on antiplatelet/anticoagulation (AP/AC) therapy. Methods A single center, retrospective study was conducted on 342 pituitary adenoma patients, of which 77 patients presented with PA (23%). Several potential risk factors for PA were assessed, including: patient demographics, tumor characteristics, pre-operative hormone replacement, neurologic deficits, coagulation studies, platelet count, and AP/AC therapy. Results Comparing patients with and without apoplexy, there was no significant difference in the proportion of patients taking aspirin (45 no apoplexy vs. 10 apoplexy; p = 0.5), clopidogrel (10 no apoplexy vs. 4 apoplexy; p = 0.5), and anticoagulation (7 no apoplexy vs. 3 apoplexy; p = 0.7). However, male sex (p-value