ECE2019 Poster Presentations Adrenal and Neuroendocrine Tumours 2 (60 abstracts)
Diagnostic accuracy of the aldosterone to active renin ratio in detecting primary aldosteronism: the graz endocrine causes of hypertension (GECOH) study
Stefan Pilz 1 , Martin Keppel 2 , Christian Trummer 1 , Verena Theiler-Schwetz 1 , Marlene Pandis 1 , Valentin Borzan 1 , Matthias Pittrof 1 , Barbara Obermayer-Pietsch 1 , Martin R Grübler 3 , Nicolas Verheyen 4 , Vinzenz Stepan 1 , Andreas Meinitzer 5 , Jakob Voelkl 6 , Winfried März 5 & Andreas Tomaschitz 7
1Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria; 2University Institute for Medical and Chemical Laboratory Diagnostics, Paracelsus Medical University, Salzburg, Austria; 3Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Bern, Switzerland; 4Department of Cardiology, Medical University of Graz, Graz, Austria; 5Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical, University of Graz, Graz, Austria; 6Institute for Physiology, Johannes Kepler University Linz, Linz, Austria; 7Bad Gleichenberg Clinic, Bad Gleichenberg, Austria.
Context: The aldosterone to active renin ratio (AARR) is the recommended screening test for primary aldosteronism (PA), but prospective study data on its sensitivity and specificity are sparse.
Objective: We investigated the diagnostic accuracy of the AARR for detecting PA.
Design: This is a prospective diagnostic accuracy study.
Setting: This study was conducted from February 2009 to August 2015 at the outpatient clinic of the Department of Endocrinology and Diabetology of the Medical University of Graz, Austria.
Participants: We included 400 patients with arterial hypertension who were referred to our tertiary care center for screening for endocrine hypertension.
Intervention: Participants had a determination of the AARR (index test) and a second AARR determination followed by a saline infusion test (SIT) after 2 two 6 weeks. PA was diagnosed in individuals with any AARR of ≥3.7 ng/dl/μU/ml (including a plasma aldosterone concentration [PAC] of ≥9 ng/dl) who had a PAC of ≥10 ng/dl after the SIT. We did not substantially alter antihypertensive drug intake.
Main outcome measures: Primary outcome was the receiver operating characteristic (ROC) curve of the AARR in diagnosing PA.
Results: Eligible for analyses were 382 participants and PA was diagnosed in 18 patients (4.7%). The area under the ROC curve of the AARR in detecting PA was 0.973 (95% confidence interval [CI]: 0.956–0.990). Sensitivity and specificity for a positive AARR in diagnosing PA was 100% (95% CI: 81.5–100.0) and 89.6% (95% CI: 86.0–92.5), respectively.
Conclusions: The AARR has a good diagnostic accuracy for detecting PA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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