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Long term outcome of Aldosteronism after target treatments
There exists a great knowledge gap in terms of long-term effects of various surgical and pharmacological treatments on outcomes among primary aldosteronism (PA) patients. Using a validated algorithm, we extracted longitudinal data for all PA patients diagnosed in 1997–2010 and treated in the Taiwan...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009379/ https://www.ncbi.nlm.nih.gov/pubmed/27586402 http://dx.doi.org/10.1038/srep32103 |
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author | Wu, Vin-Cent Wang, Shuo-Meng Chang, Chia-Hui Hu, Ya-Hui Lin, Lian-Yu Lin, Yen-Hung Chueh, Shih-Chieh Jeff Chen, Likwang Wu, Kwan-Dun |
author_facet | Wu, Vin-Cent Wang, Shuo-Meng Chang, Chia-Hui Hu, Ya-Hui Lin, Lian-Yu Lin, Yen-Hung Chueh, Shih-Chieh Jeff Chen, Likwang Wu, Kwan-Dun |
author_sort | Wu, Vin-Cent |
collection | PubMed |
description | There exists a great knowledge gap in terms of long-term effects of various surgical and pharmacological treatments on outcomes among primary aldosteronism (PA) patients. Using a validated algorithm, we extracted longitudinal data for all PA patients diagnosed in 1997–2010 and treated in the Taiwan National Health Insurance. We identified 3362 PA patients for whom the mean length of follow-up was 5.75 years. PA has higher major cardiovascular events (MACE) than essential hypertension (23.3% vs 19.3%, p = 0.015). Results from the Cox model suggest a strong effect of adrenalectomy on lowering mortality (HR = 0.23 with residual hypertension and 0.21 with resolved hypertension). While need for receptor antagonist (MRA) MRA after diagnosis suggests that a defined daily dose (DDD) of MRA between 12.5 and 50 mg may alleviate risk of death in a U-shape pattern. A specificity test identified patients who has aldosterone producing adenoma (HR = 0.50, p = 0.005) also confirmed adrenalectomy attenuated all-cause mortality. Adrenalectomy decreases long-term all-cause mortality independently from PA cure from hypertension. Prescription corresponding to a DDD between 12.5 and 50 mg may decrease mortality for patients needing MRA. It calls for more attention on early diagnosis, early treatment and prescription of appropriate dosage of MRA for PA patients. |
format | Online Article Text |
id | pubmed-5009379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-50093792016-09-12 Long term outcome of Aldosteronism after target treatments Wu, Vin-Cent Wang, Shuo-Meng Chang, Chia-Hui Hu, Ya-Hui Lin, Lian-Yu Lin, Yen-Hung Chueh, Shih-Chieh Jeff Chen, Likwang Wu, Kwan-Dun Sci Rep Article There exists a great knowledge gap in terms of long-term effects of various surgical and pharmacological treatments on outcomes among primary aldosteronism (PA) patients. Using a validated algorithm, we extracted longitudinal data for all PA patients diagnosed in 1997–2010 and treated in the Taiwan National Health Insurance. We identified 3362 PA patients for whom the mean length of follow-up was 5.75 years. PA has higher major cardiovascular events (MACE) than essential hypertension (23.3% vs 19.3%, p = 0.015). Results from the Cox model suggest a strong effect of adrenalectomy on lowering mortality (HR = 0.23 with residual hypertension and 0.21 with resolved hypertension). While need for receptor antagonist (MRA) MRA after diagnosis suggests that a defined daily dose (DDD) of MRA between 12.5 and 50 mg may alleviate risk of death in a U-shape pattern. A specificity test identified patients who has aldosterone producing adenoma (HR = 0.50, p = 0.005) also confirmed adrenalectomy attenuated all-cause mortality. Adrenalectomy decreases long-term all-cause mortality independently from PA cure from hypertension. Prescription corresponding to a DDD between 12.5 and 50 mg may decrease mortality for patients needing MRA. It calls for more attention on early diagnosis, early treatment and prescription of appropriate dosage of MRA for PA patients. Nature Publishing Group 2016-09-02 /pmc/articles/PMC5009379/ /pubmed/27586402 http://dx.doi.org/10.1038/srep32103 Text en Copyright © 2016, The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Article Wu, Vin-Cent Wang, Shuo-Meng Chang, Chia-Hui Hu, Ya-Hui Lin, Lian-Yu Lin, Yen-Hung Chueh, Shih-Chieh Jeff Chen, Likwang Wu, Kwan-Dun Long term outcome of Aldosteronism after target treatments |
title | Long term outcome of Aldosteronism after target treatments |
title_full | Long term outcome of Aldosteronism after target treatments |
title_fullStr | Long term outcome of Aldosteronism after target treatments |
title_full_unstemmed | Long term outcome of Aldosteronism after target treatments |
title_short | Long term outcome of Aldosteronism after target treatments |
title_sort | long term outcome of aldosteronism after target treatments |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009379/ https://www.ncbi.nlm.nih.gov/pubmed/27586402 http://dx.doi.org/10.1038/srep32103 |
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