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01-03-2017 | ORIGINAL ARTICLE

Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients

Authors: Ludwig Pasquier, Medhi Kirouani, Florian Fanget, Claire Nomine, Cécile Caillard, Vincent Arnault, Jean-Baptiste Finel, Niki Christou, Muriel Mathonnet, Christophe Trésallet, Antoine Hamy, Loïc de Calan, Laurent Brunaud, Fabrice Menegaux, Jean Christophe Lifante, Jean Benoit Hardouin, Delphine Drui, Éric Mirallié, Claire Blanchard

Published in: Langenbeck's Archives of Surgery | Issue 2/2017

Abstract

Purpose

Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population.

Method

Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Diagnosis of Aldosterone-producing adenoma (APA) was confirmed with clinical and biochemical hyperaldosteronism and adrenal nodule on CT scan. Adrenal venous sampling was performed when CT failed to identify laterality. ARS is based on four variables: female sex, BMI ≤25 kg/m², duration of hypertension ≤6 years, number of antihypertensive medications ≤2. One point is attributed for the first three and 2 points for the last. Patients were considered as cured if they had no hypertension and no antihypertensive medications at least 6 months after surgery. Patients with bilateral adrenal hyperplasia were excluded.

Results

This multicenter study included 310 patients with APA. ARS and follow-up were obtained in 257 patients. 46.6% of patients were cured and potassium serum level was normalized in 97.7%. In multivariate analysis, odds ratio for female sex, BMI ≤25 kg/m², duration of hypertension ≤6 years, and number of antihypertensive medications ≤2 were 1.60 (p = 0.09), 1.77 (p = 0.04), 1.28 (p = 0.4), 3.41 (p < 0.001), respectively. Cure rate were, respectively, 22.2, 41.4 and 74% for patients with a score ARS 0–1, 2–3, 4–5. The area under the curve (AUC) of ARS was 0.715.

Conclusion

ARS is not a predictive score efficient enough in a French population maybe due to different metabolic data and genetic conditions.

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Title: Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients
Authors: Ludwig Pasquier
Medhi Kirouani
Florian Fanget
Claire Nomine
Cécile Caillard
Vincent Arnault
Jean-Baptiste Finel
Niki Christou
Muriel Mathonnet
Christophe Trésallet
Antoine Hamy
Loïc de Calan
Laurent Brunaud
Fabrice Menegaux
Jean Christophe Lifante
Jean Benoit Hardouin
Delphine Drui
Éric Mirallié
Claire Blanchard
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 2/2017
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1557-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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