Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
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
_version_ 1782451516049719296
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
work_keys_str_mv AT wuvincent longtermoutcomeofaldosteronismaftertargettreatments
AT wangshuomeng longtermoutcomeofaldosteronismaftertargettreatments
AT changchiahui longtermoutcomeofaldosteronismaftertargettreatments
AT huyahui longtermoutcomeofaldosteronismaftertargettreatments
AT linlianyu longtermoutcomeofaldosteronismaftertargettreatments
AT linyenhung longtermoutcomeofaldosteronismaftertargettreatments
AT chuehshihchiehjeff longtermoutcomeofaldosteronismaftertargettreatments
AT chenlikwang longtermoutcomeofaldosteronismaftertargettreatments
AT wukwandun longtermoutcomeofaldosteronismaftertargettreatments