Open AccessIncidental Congestive Heart Failure in Patients With Aldosterone‐Producing Adenomas
Author(s) -
Huang WeiChieh,
Chen YingYing,
Lin YenHung,
Chen Likwang,
Lin PoChih,
Lin YuFeng,
Liu YuChun,
Wu CheHsiung,
Chueh Jeff S.,
Chu TzongShinn,
Wu Kwan Dun,
Huang ChunYao,
Wu VinCent
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.012410
Subject(s) - medicine , primary aldosteronism , heart failure , hazard ratio , aldosterone , cardiology , adrenalectomy , hyperaldosteronism , urology , confidence interval
Background Previous studies show that patients with primary aldosteronism are associated with higher risk of congestive heart failure ( CHF ). However, the effect of target treatment to the incidental CHF has not been elucidated. We aimed to investigate the risk of new‐onset CHF in patients with aldosterone‐producing adenomas ( APAs ) and explore the effect of adrenalectomy on new onset of CHF . Methods and Results From 1997 to 2009, 688 APA were identified and matched with essential hypertension controls. The risks of developing incidental CHF (hazard ratio, 0.49; 95% CI , 0.31–0.75; P =0.001) and mortality (hazard ratio, 0.29; 95% CI , 0.20–0.44; P <0.001) were significantly lower in the APA group after targeted treatment. A total of 605 patients with APAs who underwent adrenalectomy lowered the risks of CHF (subdistribution hazard ratio, 0.55; 95% CI , 0.34–0.90; P =0.017) and mortality (adjusted hazard ratio, 0.27; 95% CI , 0.16–0.44; P <0.001) compared with essential hypertension controls. Conclusions In conclusion, for patients with APAs, adrenalectomy can be associated with lower risk of incidental CHF and all‐cause mortality in a long‐term follow‐up.