Abstract
Glucocorticoids are potent anti-inflammatory agents that are widely used for the treatment
of many inflammatory, autoimmune, and neoplastic disorders. However, their beneficial
effect is associated with several side effects, including an increased risk of cardiovascular
complications, such as myocardial infarction and stroke. Whether their use also contributes
to a procoagulant state, and therefore increases the risk of venous thromboembolism
(VTE), is still a matter of debate. As an increased risk of venous thrombotic events
is described in patients with Cushing's syndrome, which is characterized by endogenous
hypercortisolism, it is reasonable to speculate that the chronic administration of
glucocorticoids may induce a hypercoagulable state. However, it seems virtually impossible
to separate the role of the drug from the underlying condition, which itself predisposes
to the development of VTE. Actually, some evidence suggests that the use of exogenous
glucocorticoids for the treatment of underlying disease and its exacerbations may
further amplify the risk of VTE. Moreover, a procoagulant state has also been reported
in healthy participants receiving oral glucocorticoids versus placebo. We have performed
a concise narrative review on available data on the influence of exogenous glucocorticoids
on hemostasis and their clinical impact on the risk of VTE.
Keywords
exogenous hypercortisolism - hypercoagulability - inflammation - steroids - thrombosis
