Validation of Existing Clinical Prediction Tools for Primary Aldosteronism Subtyping
Barbora Kološová,
Petr Waldauf,
Dan Wichterle,
Jan Kvasnička,
Tomáš Zelinka,
Ondřej Petrák,
Zuzana Krátká,
Lubomíra Forejtová,
Jan Kaván,
Jiří Widimský,
Robert Holaj
Affiliations
Barbora Kološová
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Petr Waldauf
Department of Anesthesiology, University Hospital Královské Vinohrady and 3rd Faculty of Medicine, Charles University in Prague, Šrobárova 1150/50, 100 00 Prague, Czech Republic
Dan Wichterle
Department of Cardiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 140 21 Prague, Czech Republic
Jan Kvasnička
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Tomáš Zelinka
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Ondřej Petrák
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Zuzana Krátká
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Lubomíra Forejtová
Department of Radiology, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Jan Kaván
Department of Radiology, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Jiří Widimský
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
Robert Holaj
Centre for Hypertension, 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, U Nemocnice 504/1, 128 08 Prague, Czech Republic
The new clinical prediction score (SCORE) has been recently proposed for primary aldosteronism (PA) subtyping prior to adrenal vein sampling (AVS). This study aimed to compare that SCORE with previously published scores and their validation using a cohort of patients at our center who had had positive SIT confirming PA and had been diagnosed with either bilateral PA according to AVS or unilateral PA if biochemically cured after an adrenalectomy. Final diagnoses were used to evaluate the diagnostic performance of the proposed clinical prediction tools. Only Kamemura’s model (with a maximum score of 4 points) and Kobayashi’s score (with a maximum score of 12 points) reached 100% reliability for prediction of bilateral PA; however, with sensitivity of only 3%. On the other hand, the values of SCORE = 3 (with sensitivity of 48%), the SPACE score ≥18 (with sensitivity of 35%), the Kobayashi’s score ≤2 (with sensitivity of 28%), and the Kocjan’s score = 3 (with sensitivity of 28%) were able to predict unilateral PA with 100% probability. Furthermore, Umakoshi’s and Young’s models both reached 100% reliability for a unilateral PA with score = 4 and both predictive factors together respectively; however, the sensitivity was lower compared with previous models; 4% and 14%, respectively. None of the clinical prediction tools applied to our cohort predicted unilateral and bilateral subtypes together with the expected high diagnostic performance, and therefore can only be used for precisely defined cases.