Evaluating the impact of adrenalectomy and mineralocorticoid receptor antagonists for primary aldosteronism on left ventricular remodeling: a systematic review and meta-analysis
Pooled result · Reduction in LVMIResult — go to the resultDifference-in-differences SMD −0.15 95% CI −0.26 to −0.03Authors' conclusion
This meta-analysis suggests that both adrenalectomy and MRAs improve LV remodeling. Although adrenalectomy was generally associated with slightly greater LVMI reductions than MRAs, the impact of optimized MRA therapy on LVMI reduction remains uncertain. When focusing specifically on patients with unilateral PA, adrenalectomy was associated with more pronounced regression of LV remodeling compared with MRA therapy.
Study context
- Population
- Patients with primary aldosteronism (PA)
- Participants
- 1,197 patients10 studies
- Comparison
- Adrenalectomy vs mineralocorticoid receptor antagonists (MRAs)
- Outcome
- Reduction in left ventricular (LV) mass index (LVMI) after treatment
Pooled result
Reduction in LVMI
Difference-in-differences SMD
−0.15
95% CI −0.26 to −0.03
By group
Adrenalectomy
−0.49
95% CI −0.65 to −0.33
SMD
MRAs
−0.35
95% CI −0.48 to −0.22
SMD
As reported in the abstract
Further pooled results
LV mass index (LVMI) reduction in unilateral PA studies
- Adrenalectomy demonstrated greater LVMI reduction than MRAs
Original publication
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