Screening for primary aldosteronism on and off interfering medications.
Antihypertensives
Cut-off
Diagnostic accuracy
Primary aldosteronism
Journal
Endocrine
ISSN: 1559-0100
Titre abrégé: Endocrine
Pays: United States
ID NLM: 9434444
Informations de publication
Date de publication:
05 Oct 2023
05 Oct 2023
Historique:
received:
11
07
2023
accepted:
31
08
2023
medline:
5
10
2023
pubmed:
5
10
2023
entrez:
5
10
2023
Statut:
aheadofprint
Résumé
To determine whether antihypertensives will affect diagnostic accuracy of the aldosterone-to-renin ratio (ARR) to an extent that is clinically relevant. Confirmatory tests were used to confirm or exclude PA diagnosis. Area under the receiver operating characteristic curve (AUC), specificity and sensitivity of ARR performance in different conditions were calculated. 208 PA and 78 essential hypertension (EH), and 125 PA and 206 EH patients, were included in the retrospective and prospective cohort, respectively. AUC of ARR on interfering medications was comparable to ARR off interfering medications (retrospective: 0.82 vs. 0.87, p = 0.20; prospective: 0.78 vs. 0.84, p = 0.07). At a threshold of 20 pg/μIU, the sensitivity of ARR on interfering medications was lower (11.1-23.2%) while the specificity was higher (10.2-15.2%) than ARR off interfering medications. However, when the ARR threshold on interfering medications was lowered to 10 pg/μIU, both the sensitivity (retrospective: 0.91 vs. 0.90, p = 0.61; prospective: 0.86 vs. 0.82, p = 0.39) and specificity (retrospective: 0.49 vs. 0.59, p = 0.20; prospective: 0.58 vs. 0.66, p = 0.10) were comparable to the ARR threshold off interfering medications. Using ARR to screen for PA whilst taking interfering antihypertensive drugs is feasible in most cases, but the ARR threshold needs to be reduced. ClinicalTrials.gov identifier: NCT04991961.
Identifiants
pubmed: 37796417
doi: 10.1007/s12020-023-03520-6
pii: 10.1007/s12020-023-03520-6
doi:
Banques de données
ClinicalTrials.gov
['NCT04991961']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : the National Natural Science Foundation of China
ID : 82100833
Organisme : the National Natural Science Foundation of China
ID : U21A20355
Organisme : Joint Medical Research Project of Chongqing Science and Technology Commission & Chongqing Health and Family Planning Commission
ID : Major Project, 2022ZDXM003
Organisme : National key research & development plan of China, major project of prevention and treatment for common diseases
ID : 2021YFC2501600, sub-project: 2021YFC2501603
Organisme : The National Key Research and Development Project
ID : 2022YFC2505300, sub-project 2022YFC2505301
Investigateurs
Mei Mei
(M)
Suxin Luo
(S)
Kangla Liao
(K)
Yao Zhang
(Y)
Yunfeng He
(Y)
Yihong He
(Y)
Ming Xiao
(M)
Bin Peng
(B)
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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