Incident CVD risk in prolactinoma elevated only in male patients
Men with prolactinoma are at an increased risk of developing cardiovascular disease (CVD), whereas there is no evidence to suggest such an increase in female patients, according to a study.
Researchers drew data from The Health Improvement Network database, identifying 2,233 patients with prolactinoma and 10,355 controls matched according to sex, age, body mass index and smoking status.
The primary outcome was any incident CVD (myocardial infarction, angina pectoris, stroke, transient ischaemic attack or heart failure), the sex-specific adjusted incidence rate ratios (aIRRs) of which were calculated using Poisson regression. Sensitivity analyses were also performed.
The composite CVD outcome occurred in 54 prolactinoma patients and 180 controls during the 6-year observation period, resulting in an incidence rate of 1.8 and 14.8 per 1,000 person-years in females and males, respectively.
Estimated aIRRs for CVD were 0.99 (95 percent CI, 0.61 to 1.61; p=0.968) in female patients and 1.94 (1.29 to 2.91; p=0.001) in male patients. The gender-specific difference in the incidence of CVD was maintained through sensitivity analyses limited to patients with documented record of dopamine agonist treatment and those with newly diagnosed prolactinoma.
Researchers pointed out that the CVD risk in male patients remained elevated even in the presence of concurrent documented treatment with dopamine agonist. Potential mechanisms underlying the association between prolactinoma and CVD might include long-standing hyperprolactinaemia and its consequences, as well as hypopituitarism and its management.
The impact of the present gender-specific finding on the long-term mortality of prolactinoma patients has yet to be elucidated, researchers added.