New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies

BackgroundPrimary aldosteronism (PA) is a common cause of secondary hypertension and associated with higher incidence of new-onset atrial fibrillation (NOAF). However, the effects of surgical or medical therapies on preventing NOAF in PA patents remain unclear. The aim of this meta-analysis study wa...

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Main Authors: Cheng-Hsuan Tsai, Ya-Li Chen, Chien-Ting Pan, Yen-Tin Lin, Po-Chin Lee, Yu-Wei Chiu, Che-Wei Liao, Zheng-Wei Chen, Chin-Chen Chang, Yi-Yao Chang, Chi-Sheng Hung, Yen-Hung Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2021.646933/full
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author Cheng-Hsuan Tsai
Cheng-Hsuan Tsai
Ya-Li Chen
Chien-Ting Pan
Yen-Tin Lin
Po-Chin Lee
Yu-Wei Chiu
Yu-Wei Chiu
Che-Wei Liao
Zheng-Wei Chen
Chin-Chen Chang
Yi-Yao Chang
Chi-Sheng Hung
Yen-Hung Lin
author_facet Cheng-Hsuan Tsai
Cheng-Hsuan Tsai
Ya-Li Chen
Chien-Ting Pan
Yen-Tin Lin
Po-Chin Lee
Yu-Wei Chiu
Yu-Wei Chiu
Che-Wei Liao
Zheng-Wei Chen
Chin-Chen Chang
Yi-Yao Chang
Chi-Sheng Hung
Yen-Hung Lin
author_sort Cheng-Hsuan Tsai
collection DOAJ
description BackgroundPrimary aldosteronism (PA) is a common cause of secondary hypertension and associated with higher incidence of new-onset atrial fibrillation (NOAF). However, the effects of surgical or medical therapies on preventing NOAF in PA patents remain unclear. The aim of this meta-analysis study was to assess the risk of NOAF among PA patients receiving mineralocorticoid receptor antagonist (MRA) treatment, PA patients receiving adrenalectomy, and patients with essential hypertension.MethodsWe performed the meta-analysis of the randomized or observational studies that investigated the incidence rate of NOAF in PA patients receiving MRA treatment versus PA patients receiving adrenalectomy from database inception until December 01, 2020 which were identified from PubMed, Embase, and Cochrane Library.ResultsA total of 172 related studies were reviewed, of which three fulfilled the inclusion criteria, including a total of 2,705 PA patients. The results of meta-analysis demonstrated a higher incidence of NOAF among the PA patients receiving MRA treatment compared to the PA patients receiving adrenalectomy (pooled odds ratio [OR]: 2.83, 95% confidence interval [CI]: 1.76–4.57 in the random effects model, I2 = 0%). The pooled OR for the PA patients receiving MRA treatment compared to the patients with essential hypertension was 1.91 (95% CI: 1.11–3.28). The pooled OR for the PA patients receiving adrenalectomy compared to the patients with essential hypertension was 0.70 (95% CI: 0.28–1.79).ConclusionCompared to the essential hypertension patients and the PA patients receiving adrenalectomy, the patients with PA receiving MRA treatment had a higher risk of NOAF.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021222022.
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spelling doaj.art-cfd249569e8c4828b0024b582cbf40ef2022-12-21T18:28:50ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-05-011210.3389/fendo.2021.646933646933New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three StudiesCheng-Hsuan Tsai0Cheng-Hsuan Tsai1Ya-Li Chen2Chien-Ting Pan3Yen-Tin Lin4Po-Chin Lee5Yu-Wei Chiu6Yu-Wei Chiu7Che-Wei Liao8Zheng-Wei Chen9Chin-Chen Chang10Yi-Yao Chang11Chi-Sheng Hung12Yen-Hung Lin13Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, TaiwanDepartment of Internal Medicine, Taoyuan General Hospital, Taoyuan, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanCardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Computer Science and Engineering, Yuan Ze University, Taoyuan City, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanCardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanBackgroundPrimary aldosteronism (PA) is a common cause of secondary hypertension and associated with higher incidence of new-onset atrial fibrillation (NOAF). However, the effects of surgical or medical therapies on preventing NOAF in PA patents remain unclear. The aim of this meta-analysis study was to assess the risk of NOAF among PA patients receiving mineralocorticoid receptor antagonist (MRA) treatment, PA patients receiving adrenalectomy, and patients with essential hypertension.MethodsWe performed the meta-analysis of the randomized or observational studies that investigated the incidence rate of NOAF in PA patients receiving MRA treatment versus PA patients receiving adrenalectomy from database inception until December 01, 2020 which were identified from PubMed, Embase, and Cochrane Library.ResultsA total of 172 related studies were reviewed, of which three fulfilled the inclusion criteria, including a total of 2,705 PA patients. The results of meta-analysis demonstrated a higher incidence of NOAF among the PA patients receiving MRA treatment compared to the PA patients receiving adrenalectomy (pooled odds ratio [OR]: 2.83, 95% confidence interval [CI]: 1.76–4.57 in the random effects model, I2 = 0%). The pooled OR for the PA patients receiving MRA treatment compared to the patients with essential hypertension was 1.91 (95% CI: 1.11–3.28). The pooled OR for the PA patients receiving adrenalectomy compared to the patients with essential hypertension was 0.70 (95% CI: 0.28–1.79).ConclusionCompared to the essential hypertension patients and the PA patients receiving adrenalectomy, the patients with PA receiving MRA treatment had a higher risk of NOAF.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021222022.https://www.frontiersin.org/articles/10.3389/fendo.2021.646933/fullhyperaldosteronismprimary aldosteronismadrenalectomymineralocorticoid receptor antagonistatrial fibrillation
spellingShingle Cheng-Hsuan Tsai
Cheng-Hsuan Tsai
Ya-Li Chen
Chien-Ting Pan
Yen-Tin Lin
Po-Chin Lee
Yu-Wei Chiu
Yu-Wei Chiu
Che-Wei Liao
Zheng-Wei Chen
Chin-Chen Chang
Yi-Yao Chang
Chi-Sheng Hung
Yen-Hung Lin
New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
Frontiers in Endocrinology
hyperaldosteronism
primary aldosteronism
adrenalectomy
mineralocorticoid receptor antagonist
atrial fibrillation
title New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
title_full New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
title_fullStr New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
title_full_unstemmed New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
title_short New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies
title_sort new onset atrial fibrillation in patients with primary aldosteronism receiving different treatment strategies systematic review and pooled analysis of three studies
topic hyperaldosteronism
primary aldosteronism
adrenalectomy
mineralocorticoid receptor antagonist
atrial fibrillation
url https://www.frontiersin.org/articles/10.3389/fendo.2021.646933/full
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