Emerging cardiovascular risk factors/markers such as proinflammatory cytokines , C-reactive protein , and adipokines are also increased in GHD patients .
Increased cardiovascular morbidity and mortality have also been reported in GHD .
GH treatment has been shown to improve both traditional and emerging cardiovascular risk factors and markers .
The GHD population may be considered at high cardiovascular risk , and GH substitution may be expected to bring an added value to patients with hypopituitarism in terms of cardiovascular protection .
CONTEXT GH deficiency ( GHD ) of the adult is a clinical condition characterized by the presence of several traditional and emerging cardiovascular risk factors that can significantly increase cardiovascular morbidity and mortality .
It is still an open issue whether GH replacement is able not only to improve cardiovascular risk factors but also to decrease cardiovascular morbidity and mortality .
EVIDENCE SYNTHESIS In untreated GHD , cardiovascular risk is increased due to abnormal lipid profile ( increased total and low-density lipoprotein cholesterol , increased triglycerides , and reduced high-density lipoprotein cholesterol ) and impaired glucose metabolism .
Hemostatic risk factors in patients with coronary artery disease and type 2 diabetes - a two year follow-up of 243 patients
BackgoundThrombosis is regarded to be a key factor in the development of acute coronary syndromes in patients with coronary artery disease ( CAD ) . We hypothesize , that hemostatic and rheological risk factors may be of major relevance for the incidence and the risk stratification of these patients . Methods In 243 patients with coronary artery disease and stable angina pectoris parameters of metabolism , hemostasis , blood rheology and endogenous fibrinolysis were assessed . Patients were prospect ively followed for 2 years in respect to elective revascularizations and acute coronary syndromes . Results During follow-up 88 patients presented with cardiac events , 22 of those were admitted to the hospital because of acute events , 5 Patients were excluded due to non- cardiac death . Patients with clinical events were found to be more frequently diabetic and presented with a more progressed coronary atherosclerosis . Even though patients with diabetes mellitus demonstrated a comparable level of multivessel disease ( 71 % vs. 70 % ) the rate of elective revascularization  was higher ( 41 % vs. 28 % , p < 0.05 ) . The results were also unfavorable for the incidence of acute cardiovascular events ( 18 % vs. 8 % , p < 0.01 ) . In comparison to non-diabetic patients diabetics demonstrated significantly elevated levels of fibrinogen ( 352 ± 76 vs. 312 ± 64 mg/dl , p < 0.01 ) , plasma viscosity ( 1.38 ± 0.23 vs. 1.31 ± 0.16 mPas , p < 0.01 ) , red blood cell aggregation ( 13.2 ± 2.5 vs. 12.1 ± 3.1 E , p < 0.05 ) and plasmin-activator-inhibitor ( 6.11 ± 3.4 vs. 4.7 ± 2.7 U/l , p < 0.05 ) . Conclusion Pathological alterations of fibrinogen , blood rheology and plasminogen-activator-inhibtor as indicators of a procoagulant state are of major relevance for the short-term incidence of cardiac events , especially in patients with diabetes mellitus type 2 , and may be used to stratify patients to specific therapies
Emerging cardiovascular risk factors/markers such as proinflammatory cytokines , C-reactive protein , and adipokines are also increased in GHD patients .
Increased cardiovascular morbidity and mortality have also been reported in GHD .
GH treatment has been shown to improve both traditional and emerging cardiovascular risk factors and markers .
The GHD population may be considered at high cardiovascular risk , and GH substitution may be expected to bring an added value to patients with hypopituitarism in terms of cardiovascular protection .
CONTEXT GH deficiency ( GHD ) of the adult is a clinical condition characterized by the presence of several traditional and emerging cardiovascular risk factors that can significantly increase cardiovascular morbidity and mortality .
It is still an open issue whether GH replacement is able not only to improve cardiovascular risk factors but also to decrease cardiovascular morbidity and mortality .
EVIDENCE SYNTHESIS In untreated GHD , cardiovascular risk is increased due to abnormal lipid profile ( increased total and low-density lipoprotein cholesterol , increased triglycerides , and reduced high-density lipoprotein cholesterol ) and impaired glucose metabolism .