{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T23:10:09Z","timestamp":1744326609992,"version":"3.40.4"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/501100018867","name":"Heinz Nixdorf Foundation","doi-asserted-by":"crossref","award":["ER-155\/6-2"],"award-info":[{"award-number":["ER-155\/6-2"]}],"id":[{"id":"10.13039\/501100018867","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Clinician Scientist Programme UMEA","award":["FU 356\/12-1"],"award-info":[{"award-number":["FU 356\/12-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cushing\u2019s syndrome (CS) is associated with high morbidity and mortality triggered\n                    by increased risk for cardiovascular events. Nevertheless, no screening tool to\n                    predict the individual risk for these events in patients with Cushing\u2019s syndrome\n                    has been established. Nonenhanced electron-beam computed tomography scans with\n                    calculation of the Coronary Artery Calcium (CAC) score may offer a non-invasive\n                    method. Hence, we evaluated the diagnostic accuracy of Agatston score to predict\n                    the risk of a cardiac event in patients with Cushing\u2019s syndrome. Single center\n                    prospective study of 34 patients with endogenous CS Multidetector computer\n                    tomography and calculation of CAC score was performed at diagnosis of CS.\n                    Prevalence of cardiovascular events was documented with median follow-up over 5\n                    years and results were compared with data from the Heinz Nixdorf Recall (HNR)\n                    Study. In addition, correlations of CAC score with parameters of cortisol excess\n                    were evaluated. CAC score was significantly higher in CS patients with a\n                    cardiovascular event than in patients without an event (117 vs. 90; p=&lt;0.01).\n                    An odds ratio of 31.7 (p=0.03, 95% CI: 1.3\u2013773.0) for a cardiovascular event\n                    could be shown in Cushing\u2019s syndrome patients with a CAC score&gt;75th risk\n                    factor-specific reference percentile, while the odds ratio in the HNR study was\n                    4.5 (p&lt;0.01, 95% CI: 3.0\u20136.9). No correlation between the degree of cortisol\n                    excess and CAC score was evident. The CAC score&gt;75th risk factor-specific\n                    reference percentile could offer a useful screening tool to precise the\n                    cardiovascular risk in patients with Cushing\u2019s syndrome. <\/jats:p>","DOI":"10.1055\/a-2541-9821","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:25:26Z","timestamp":1742257526000},"page":"229-235","source":"Crossref","is-referenced-by-count":0,"title":["The Coronary Artery Calcium Score as Prognostic Tool for\n                    Cardiovascular Events in Patients with Cushing\u2019s Syndrome"],"prefix":"10.1055","volume":"57","author":[{"given":"Lukas","family":"van Baal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University\n                    Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometrics and\n                    Epidemiology, University Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl-Heinz","family":"J\u00f6ckel","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometrics and\n                    Epidemiology, University Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimund","family":"Erbel","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometrics and\n                    Epidemiology, University Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lale","family":"Umutlu","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology and\n                    Neuroradiology, University Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology and\n                    Neuroradiology, University Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"F\u00fchrer","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University\n                    Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Unger","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University\n                    Hospital Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"5593","DOI":"10.1210\/jc.2003-030871","article-title":"Diagnosis and complications of Cushing's syndrome: a consensus\n                    statement","volume":"88","author":"G Arnaldi","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/j.1365-2265.2009.03610.x","article-title":"Should we evaluate for cardiovascular disease in patients with Cushing\u2019s\n                    syndrome?","volume":"71","author":"F Fallo","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1161\/01.ATV.20.5.1262","article-title":"Lessons from sudden coronary death","volume":"20","author":"R Virmani","year":"2000","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.atherosclerosis.2005.06.003","article-title":"Population-based assessment of subclinical coronary atherosclerosis using\n                    electron-beam computed tomography","volume":"185","author":"A Schmermund","year":"2006","journal-title":"Atherosclerosis"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1148\/radiol.2473071469","article-title":"Coronary calcium coverage score: determination, correlates, and predictive\n                    accuracy in the Multi-Ethnic Study of Atherosclerosis","volume":"247","author":"E R Brown","year":"2008","journal-title":"Radiology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed\n                    tomography","volume":"15","author":"A S Agatston","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.atherosclerosis.2007.02.031","article-title":"Sex related cardiovascular risk stratification based on quantification of\n                    atherosclerosis and inflammation","volume":"197","author":"R Erbel","year":"2008","journal-title":"Atherosclerosis"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jacc.2008.07.072","article-title":"Coronary calcium predicts events better with absolute calcium scores than\n                    age-sex-race\/ethnicity percentiles: MESA (Multi-Ethnic Study of\n                    Atherosclerosis)","volume":"53","author":"M J Budoff","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s10654-012-9743-1","article-title":"Screening results for subclinical coronary artery calcification in asymptomatic\n                    individuals in relation to a detailed parental history of premature coronary\n                    heart disease","volume":"28","author":"S Wahl","year":"2013","journal-title":"Eur J Epidemiol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"2782","DOI":"10.1093\/eurheartj\/ehn439","article-title":"Signs of subclinical coronary atherosclerosis in relation to risk factor\n                    distribution in the Multi-Ethnic Study of Atherosclerosis (MESA) and the Heinz\n                    Nixdorf Recall Study (HNR)","volume":"29","author":"R Erbel","year":"2008","journal-title":"Eur Heart J"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification\n                    to reduce cardiovascular risk","volume":"41","author":"F Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1055\/s-2004-830418","article-title":"Coronary calcification in long-term type 1 diabetic patients -- a study with\n                    multi slice spiral computed tomography","volume":"112","author":"C Thilo","year":"2004","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1055\/s-0029-1214386","article-title":"Impact of disease duration on coronary calcification in patients with\n                    acromegaly","volume":"117","author":"B L Herrmann","year":"2009","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1067\/mhj.2002.123579","article-title":"Assessment of clinically silent atherosclerotic disease and established and\n                    novel risk factors for predicting myocardial infarction and cardiac death in\n                    healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL\n                    Study. Risk factors, evaluation of coronary calcium and lifestyle","volume":"144","author":"A Schmermund","year":"2002","journal-title":"Am Heart J"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing's syndrome: an endocrine society clinical practice\n                    guideline","volume":"93","author":"L K Nieman","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00103-012-1490-7","article-title":"[The Heinz Nixdorf Recall study]","volume":"55","author":"R Erbel","year":"2012","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung\n                    Gesundheitsschutz"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"2960","DOI":"10.1093\/eurheartj\/ehu288","article-title":"Progression of coronary artery calcification seems to be inevitable, but\n                    predictable \u2013 results of the Heinz Nixdorf Recall (HNR) study","volume":"35","author":"R Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1007\/s12350-010-9218-2","article-title":"Diagnostic accuracy of 64-slice computed tomography coronary angiography for the\n                    detection of in-stent restenosis: a meta-analysis","volume":"17","author":"N Carrabba","year":"2010","journal-title":"J Nucl Cardiol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1210\/jc.2012-3754","article-title":"Hypercortisolism is associated with increased coronary arterial atherosclerosis:\n                    analysis of noninvasive coronary angiography using multidetector computerized\n                    tomography","volume":"98","author":"N M Neary","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1210\/jc.2012-3547","article-title":"Coronary artery disease detected by multislice computed tomography in patients\n                    after long-term cure of Cushing's syndrome","volume":"98","author":"M J Barahona","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s12020-012-9764-2","article-title":"Coronary microvascular function in patients with Cushing's syndrome","volume":"43","author":"F Fallo","year":"2013","journal-title":"Endocrine"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/BF03345709","article-title":"Blood coagulation and fibrinolysis in patients with Cushing's syndrome:\n                    increased plasminogen activator inhibitor-1, decreased tissue factor pathway\n                    inhibitor, and unchanged thrombin-activatable fibrinolysis inhibitor levels","volume":"32","author":"C Erem","year":"2009","journal-title":"J Endocrinol Invest"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1007\/BF03347516","article-title":"Vascular endothelial growth factor (VEGF), prostaglandin E2(PGE2) and active\n                    renin in hypertension of adrenal origin","volume":"27","author":"S Zacharieva","year":"2004","journal-title":"J Endocrinol Invest"},{"key":"ref25","first-page":"3617","article-title":"11 beta-Hydroxysteroid dehydrogenase activity in Cushing's syndrome:\n                    explaining the mineralocorticoid excess state of the ectopic adrenocorticotropin\n                    syndrome","volume":"80","author":"P M Stewart","year":"1995","journal-title":"J Clin Endocrinol Metab"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1210\/en.2010-0925","article-title":"11b-hydroxysteroid dehydrogenase type 2 deficiency accelerates atherogenesis and\n                    causes proinflammatory changes in the endothelium in apoe-\/- mice","volume":"152","author":"G A Deuchar","year":"2011","journal-title":"Endocrinology"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1161\/01.CIR.0000157730.94423.4B","article-title":"Ethnic differences in coronary calcification: the Multi-Ethnic Study of\n                    Atherosclerosis (MESA)","volume":"111","author":"D E Bild","year":"2005","journal-title":"Circulation"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2541-9821.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T22:45:05Z","timestamp":1744325105000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2541-9821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":26,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,4,10]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2541-9821","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"type":"print","value":"0018-5043"},{"type":"electronic","value":"1439-4286"}],"subject":[],"published":{"date-parts":[[2025,3,17]]}}}