KCNJ5 Somatic Mutations Are Associated With Better Long-term Outcomes in Patients With Unilateral Primary Aldosteronism
Main finding · MACCEs and mortalityResult — go to the resultHazard ratio 0.46Authors' conclusion
Patients with uPA harboring KCNJ5 somatic mutations had a lower risk of long-term MACCEs and mortality following adrenalectomy. These patients were more likely to achieve complete clinical success, which contributed to improved outcomes. However, the benefits were influenced by factors such as baseline potassium levels, hypertension duration, BMI, eGFR, and residual hypertension, highlighting the interplay of genetic and clinical factors in determining prognosis.
Study context
- Population
- Patients with unilateral PA who underwent adrenalectomy 2013–2017, Taiwan Primary Aldosteronism Investigation database, followed until 2020; 46.7% men, mean age 51.3 years
- Participants
- 358 patients
- Exposure
- KCNJ5 somatic mutation carriers vs non-carriers
- KCNJ5 mutationn = 188
- Outcome
- Complete clinical success at 1 year after adrenalectomy; long-term major adverse cardiac and cerebrovascular events (MACCEs) and mortality
Methodological detailslongitudinal, population-based
- Longitudinal
- Population-based
Main finding
MACCEs and mortality · long-term
Hazard ratio
0.46
P = 0.044
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | OR for complete clinical success | P value |
|---|---|---|
| Complete clinical success · 1 year after adrenalectomyHigher likelihood with KCNJ5 mutation | 1.98 | P = 0.016 |
Baseline predictors of KCNJ5 somatic mutations
- Younger age, OR (P = .001)
- 2.44
- Lower BMI, OR (P = .005)
- 2.04
- Lower potassium, OR (P < .001)
- 6.55
- Larger tumor size, OR (P = .023)
- 2.05
Other factors associated with major adverse cardiac and cerebrovascular events (MACCEs) and mortality
- Shorter duration of hypertension (lower risk), HR (P = .008)
- 1.05
- Achieved complete clinical success (lower risk), HR (P = .036)
- 0.49
Original publication
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