Key result
AVS-imaging agreement was significantly higher in patients with KCNJ5 mutations compared to other aldosterone-driver somatic mutations (90.3% vs 64.6%; P<0.001).
Why the study?
Adrenal imaging is less accurate than AVS for PA subtyping, but AVS is invasive, technically challenging, and scarce, creating a need to identify predictors of concordance that could circumvent AVS.
What are the predictors of concordance between cross-sectional imaging and lateralized adrenal vein sampling in patients with primary aldosteronism?
Population
234 patients with PA who underwent AVS at a tertiary referral center
Comparison
Cross-sectional imaging vs lateralized AVS
Design
Retrospective single-center study
Authors
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May help select PA patients for AVS omission; leaves open whether predictors safely guide care without prospective validation.
Observational (n=234)
No
What are the predictors of concordance between cross-sectional imaging and lateralized adrenal vein sampling in patients with primary aldosteronism?
Absolute Event Rate: 90.3% vs 64.6%
p-value: p=<0.001
Although imaging-AVS concordance is higher in young, white, and Asian patients with KCNJ5 mutations, no single predictor provides absolute imaging accuracy to safely bypass AVS in primary aldosteronism.
Wannachalee et al. (2020) conducted an observational in Primary aldosteronism (n=234). KCNJ5 mutation vs. Other aldosterone-driver somatic mutations was evaluated on AVS-imaging agreement (p=<0.001). AVS-imaging agreement was significantly higher in patients with KCNJ5 mutations compared to other aldosterone-driver somatic mutations (90.3% vs 64.6%; P<0.001).
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