Please use this identifier to cite or link to this item:
https://repository.monashhealth.org/monashhealthjspui/handle/1/35421
Title: | Clinical Outcomes of 1625 Patients with Primary Aldosteronism Subtyped with Adrenal Vein Sampling. | Authors: | Widimsky J.;Chee N.Y.N.;Magill S.B.;Shafigullina Z.;Quinkler M.;Oliveras A.;Dun Wu K.;Wu V.-C.;Kratka Z.;Barbiero G.;Battistel M.;Chang C.-C.;Vanderriele P.-E.;Pessina A.C.;Rossi G.P.;Rossitto G.;Amar L.;Azizi M.;Riester A.;Reincke M.;Degenhart C.;Naruse M.;Deinum J.;Schultze Kool L.;Kocjan T.;Negro A.;Rossi E.;Kline G.;Tanabe A.;Satoh F.;Christian Rump L.;Vonend O.;Willenberg H.S.;Fuller P.J.;Yang J. | Monash Health Department(s): | Endocrinology | Institution: | (Rossi, Rossitto, Vanderriele, Pessina) Department of Medicine-DIMED, University of Padova, Hypertension Unit, University Hospital, Padova, Italy (Amar, Azizi) AP-HP, Hopital Europeen Georges Pompidou, Hypertension Unit, Paris, France (Amar) Faculty of Medicine, Universite de Paris, INSERM, UMR970, Paris-Cardiovascular Research Center, France (Azizi) INSERM, CIC1418, Paris F-75015, France (Riester, Reincke, Degenhart) Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, LMU Munchen, Germany (Widimsky, Kratka) 3rd Department of Medicine, Charles University Prague, General Hospital, Czechia (Naruse) Department of Endocrinology, National Hospital Organization Kyoto Medical Center, Clinical Research Institute, Japan (Deinum) Department of Internal Medicine (Schultze Kool) Department of Radiology (Kocjan) University Medical Centre Ljubljana, Slovenia (Negro, Rossi) Department of Internal Medicine, Azienda Unita Sanitaria Locale, IRCCS Arcispedale S. Maria Nuova, Hypertension Unit, Reggio Emilia, Italy (Kline) Foothills Medical Centre, University of Calgary, Canada (Tanabe) Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine (A.T.) (Satoh) Department of Nephrology, Tohoku University Hospital, Endocrinology and Vascular Medicine, Sendai, Japan (Christian Rump, Vonend) Heinrich Heine University Dusseldorf Nephrologie, Germany (Willenberg) Division of Endocrinology and Metabolism, Rostock University Medical Center, Germany (Fuller, Yang, Chee) Endocrinology Unit, Monash Health, Clayton, VIC, Australia (Magill) Medical College of Wisconsin, Endocrinology Center, North Hills Health Center, Menomonee Falls, United States (Quinkler) Endocrinology in Charlottenburg, Berlin, Germany (Oliveras) Department of Nephrology, Hypertension Unit, Hosp. Del Mar Universitat Autonoma de Barcelona, Spain (Dun Wu, Wu) Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan (Republic of China) (Chang) Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Republic of China) (Barbiero, Battistel) Institute of Radiology, University of Padova, Italy (Rossi) Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom | Issue Date: | 27-Feb-2020 | Copyright year: | 2019 | Publisher: | Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org) | Place of publication: | United States | Publication information: | Hypertension. 74 (4) (pp 800-808), 2019. Date of Publication: 01 Oct 2019. | Journal: | Hypertension | Abstract: | We sought to measure the clinical benefits of adrenal venous sampling (AVS), a test recommended by guidelines for primary aldosteronism (PA) patients seeking surgical cure, in a large registry of PA patients submitted to AVS. Data of 1625 consecutive patients submitted to AVS in 19 tertiary referral centers located in Asia, Australia, Europe, and North America were collected in a large multicenter international registry. The primary end points were the rate of bilateral success, ascertained lateralization of PA, adrenalectomy, and of cured arterial hypertension among AVS-guided and non AVS-guided adrenalectomy patients. AVS was successful in 80.1% of all cases but allowed identification of unilateral PA in only 45.5% by the criteria in use at each center. Adrenalectomy was performed in 41.8% of all patients and cured arterial hypertension in 19.6% of the patients, 2-fold more frequently in women than men (P<0.001). When AVS-guided, surgery provided a higher rate of cure of hypertension than when non-AVS-guided (40.0% versus 30.5%; P=0.027). Compared with surgical cases, patients treated medically needed more antihypertensive medications (P<0.001) and exhibited a higher rate of persistent hypokalemia requiring potassium supplementation (4.9% versus 2.3%; P<0.01). The low rate of adrenalectomy and cure of hypertension in PA patients seeking surgical cure indicates suboptimal AVS use, possibly related to issues in patient selection, technical success, and AVS data interpretation. Given the better outcomes of AVS-guided adrenalectomy, these results call for actions to improve the diagnostic use of this test that is necessary for detection of surgical PA candidates. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifier: NCT01234220.Copyright © 2019 American Heart Association, Inc. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13463 | PubMed URL: | 31476901 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31476901] | ISSN: | 0194-911X | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35421 | Type: | Article | Subjects: | blood sampling device/ct [Clinical Trial] cohort analysis controlled clinical trial adrenalectomy adult African African American aldosterone blood level antihypertensive therapy article Asian *blood sampling Caucasian *clinical outcome controlled study female follow up help seeking behavior Hispanic human hypertension/dt [Drug Therapy] hypokalemia/dt [Drug Therapy] long term care major clinical study male metabolic ratio middle aged mineral supplementation multicenter study plasma renin activity *primary hyperaldosteronism/su [Surgery] priority journal sex difference *suprarenal vein aldosterone/ec [Endogenous Compound] antihypertensive agent/dt [Drug Therapy] potassium/dt [Drug Therapy] renin/ec [Endogenous Compound] *adrenal venous sampling blood sampling device/ct adrenalectomy African African American aldosterone blood level antihypertensive therapy Asian blood sampling Caucasian help seeking behavior Hispanic hypertension hypokalemia long term care metabolic ratio mineral supplementation plasma renin activity primary hyperaldosteronism sex difference suprarenal vein aldosterone antihypertensive agent potassium renin adrenal venous sampling cohort analysis African controlled study female follow up help seeking behavior Hispanic human hypertension / drug therapy hypokalemia / drug therapy long term care major clinical study male metabolic ratio middle aged mineral supplementation multicenter study plasma renin activity *primary hyperaldosteronism / *surgery priority journal sex difference *suprarenal vein adult adrenalectomy controlled clinical trial African American aldosterone blood level antihypertensive therapy Article Asian *blood sampling Caucasian *clinical outcome |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
Show full item record
Items in Monash Health Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.