Hypercoagulability in Cushing Syndrome, Prevalence of Thrombotic Events

A Large, Single-Center, Retrospective Study

Maria Gabriela Suarez; Madeleine Stack; Jose Miguel Hinojosa-Amaya; Michael D. Mitchell; Elena V. Varlamov; Chris G. Yedinak; Justin S. Cetas; Brett Sheppard; Maria Fleseriu


J Endo Soc. 2020;4(2) 

In This Article


An increased awareness of thromboembolism in CS is extremely important. We show that patients with CS are at a higher risk of thromboembolism for approximately 30 to 60 days during the postoperative period. This risk is higher in patients undergoing BLA. Interestingly, the degree of hypercortisolemia or other known risk factors for TE did not correlate with risk of TE. We also found that prophylactic anticoagulation, although administered in just one-quarter of our patients, did not increase the risk of bleeding or surgical complications in patients undergoing TSS or adrenalectomy. The precise duration of prophylactic anticoagulation is unknown, but most likely should continue up to 60 days after surgery, particularly after BLA, the time frame in which patients are at a higher risk for TEs. However, further prospective investigations are required to raise awareness of the hypercoagulability risks and to optimize anticoagulant protocols along with individualized preoperative assessments of thromboembolism and bleeding risk in patients with CS.