ArticleJournal of the Endocrine Society2020
Hypercoagulability in Cushing Syndrome, Prevalence of Thrombotic Events: A Large, Single-Center, Retrospective Study.
Article in Journal of the Endocrine Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Who and how to screen for Cushing's syndrome: the position statement of the Italian Society of Endocrinology.Journal of endocrinological investigation · 2026Guideline
- Thrombosis in Cushing's disease; raising the flag of concern.Neurosurgical review · 2023Pooled it
- Relacorilant or surgery improved hemostatic markers in Cushing syndrome.Journal of endocrinological investigation · 2025Trial
- Safety and effectiveness of rivaroxaban thromboprophylaxis in adrenocorticotropic hormone-dependent Cushing syndrome.The Journal of clinical endocrinology and metabolism · 2026Article
- Article
- Cushing syndrome of different etiologies - cardiometabolic complications, venous thromboembolic events and mortality: data from ERCUSYN Krakow database.Frontiers in endocrinology · 2026Article
- Hypercoagulability in Cushing's syndrome: past, present, future.Archives of endocrinology and metabolism · 2025Review
- Article
- Unusual infections and thrombotic events in Cushing's syndrome.Journal of endocrinological investigation · 2025Review
- Acute Myocardial Infarction With Nonobstructive Coronary Arteries Across Endocrine Disorders: A Case Series.JCEM case reports · 2025Article
- Patients with Cushing's syndrome suffer from provoked venous thromboembolism and are anticoagulated in various patterns.Endocrine connections · 2024Article
- An Overview of Cardiovascular Risk in Pituitary Disorders.Medicina (Kaunas, Lithuania) · 2024Review
- Hypercoagulable state and risk of venous thromboembolism in Cushing syndrome.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Review
- The thrombotic risk in Cushing's syndrome-questions, answers, and the algorithm to consider in its assessment: part I-thrombotic risk not related to surgery.Frontiers in endocrinology · 2024Review
- An individualized approach to the management of Cushing disease.Nature reviews. Endocrinology · 2023Review
- Preventive strategies for hypercoagulation in Cushing's syndrome: when and how.Thrombosis journal · 2023Review
- Prevalence of perioperative asymptomatic venous thromboses of the lower extremity in 30 consecutive patients undergoing transsphenoidal surgery for Cushing's disease.Scientific reports · 2023Article
- Cardiac Hypertrophy and Related Dysfunctions in Cushing Syndrome Patients-Literature Review.Journal of clinical medicine · 2022Review
- Clinical Biology of the Pituitary Adenoma.Endocrine reviews · 2022Review
- Approach to the Patient: Diagnosis of Cushing Syndrome.The Journal of clinical endocrinology and metabolism · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of Cushing syndrome (CS) patients experiencing a thrombotic event (TE) is significantly higher (odds ratio; OR 18%) than that of the general population. However, there are currently no anticoagulation guidelines.
methodsA retrospective, single-center, longitudinal study of patients undergoing all types of treatment-surgical (pituitary, unilateral, and bilateral adrenalectomy) and medical treatment-was undertaken. TEs were recorded at any point up until last patient follow-up; myocardial infarction (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE) or stroke. Patients' doses and complications of anticoagulation were recorded.
resultsIncluded were 208 patients; a total of 165 (79.3%) were women, and mean age at presentation was 44 ± 14.7 years. Thirty-nine (18.2%) patients had a TE; extremity DVT (38%), cerebrovascular accident (27%), MI (21%), and PE (14%). Of 56 TEs, 27 (48%) were arterial and 29 (52%) were venous. Patients who underwent bilateral adrenalectomy (BLA) had an odds ratio of 3.74 (95% CI 1.69-8.27) of developing a TE. Of patients with TEs, 40.5% experienced the event within the first 60 days after surgery. Baseline 24-hour urinary free cortisol levels did not differ in patients with or without TE after BLA. Of 197 patients who underwent surgery, 50 (25.38%) received anticoagulation after surgery, with 2% having bleeding complications.
conclusionsThe risk of TEs in patients with CS was approximately 20%. Many patients had more than 1 event, with higher risk 30 to 60 days postoperatively. The optimal prophylactic anticoagulation duration is unknown, but most likely needs to continue up to 60 days postoperatively, particularly after BLA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.