Quantitative Value of Aldosterone-Renin Ratio for Detection of Aldosterone-Producing Adenoma: The Aldosterone-Renin Ratio for Primary Aldosteronism (AQUARR) Study

Journal of the American Heart Association
Giuseppe MaiolinoPAPY study Investigators

Abstract

Current guidelines recommend use of the aldosterone-renin ratio (ARR) for the case detection of primary aldosteronism followed by confirmatory tests to exclude false-positive results from further diagnostic workup. We investigated the hypothesis that this could be unnecessary in patients with a high ARR value if the quantitative information carried by the ARR is taken into due consideration. We interrogated 2 large data sets of prospectively collected patients studied with the same predefined protocol, which included the captopril challenge test. We used an unambiguous diagnosis of aldosterone-producing adenoma as reference index. We also assessed whether the post-captopril ARR and plasma aldosterone concentration fall furnished a diagnostic gain over baseline ARR values. We found that the false-positive rate fell exponentially, and, conversely, the specificity increased with rising ARR values. At receiver operating characteristics curves and diagnostic odds ratio analysis, the high baseline ARR values implied very high positive likelihood ratio and diagnostic odds ratio values. The baseline and post-captopril ARR showed similar diagnostic accuracy (area under the receiver operating characteristics curve) in both the explorator...Continue Reading

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Citations

Apr 8, 2017·Journal of the American College of Cardiology·Giuseppe MaiolinoGian Paolo Rossi
Mar 12, 2019·Current Pharmaceutical Design·Konstantinos StavropoulosMichael Doumas
Dec 22, 2019·Hormones : International Journal of Endocrinology and Metabolism·Stelios FountoulakisGeorge Piaditis
Apr 17, 2019·Current Hypertension Reviews·Konstantinos StavropoulosMichael Doumas
Mar 20, 2020·Scandinavian Journal of Clinical and Laboratory Investigation·Yu FuWei Liu
Mar 12, 2020·The Journal of Clinical Endocrinology and Metabolism·Junji KawashimaAkiyo Tanabe
May 7, 2020·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Satoshi KidoguchiTakashi Yokoo
Feb 19, 2020·The Journal of Clinical Endocrinology and Metabolism·Gian Paolo RossiTeresa Maria Seccia
Sep 19, 2019·Journal of the Endocrine Society·Stefan PilzAndreas Tomaschitz
Jan 9, 2020·Journal of Hypertension·Athanasios Manolis, Michael Doumas
Sep 16, 2020·Journal of Human Hypertension·Maurizio CesariGian Paolo Rossi
Feb 11, 2020·Blood Pressure·Jiří WidimskýRenata Cífkova
Nov 8, 2020·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Gian Paolo RossiTeresa Maria Seccia
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Software Mentioned

ARR App
GraphPad Prism
SPSS
MedCalc

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