{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T07:47:27Z","timestamp":1722930447429},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["15Aek0109122"],"award-info":[{"award-number":["15Aek0109122"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Although corticotropin is a representative secretagogue of aldosterone, the utility of the cosyntropin stimulation test (C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>) in diagnosing primary aldosteronism (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>) has not been elucidated. Aim of the study was to evaluate the clinical utility of C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> for confirmatory testing and subtype classification of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting and Patients<\/jats:title><jats:p>In this retrospective study, we identified patients with hypertension and positive case\u2010detection results for <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> who underwent C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> and saline infusion testing (<jats:styled-content style=\"fixed-case\">SIT<\/jats:styled-content>) between 2006 and 2013 at eight referral centres in Japan. <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> and essential hypertension (<jats:styled-content style=\"fixed-case\">EH<\/jats:styled-content>) were distinguished based on <jats:styled-content style=\"fixed-case\">SIT<\/jats:styled-content> results. <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> subtype classification was determined by adrenal venous sampling (<jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content>). Plasma aldosterone concentration (<jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>) was measured before and 30 and 60 min after intravenous cosyntropin administration. The ability of C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> to distinguish <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">EH<\/jats:styled-content> and to distinguish unilateral from bilateral disease was assessed by the area under the receiver operating characteristic curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 205 patients with hypertension and positive case\u2010detection results, 139 (68%) had <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> based on <jats:styled-content style=\"fixed-case\">SIT<\/jats:styled-content> results. Eighteen patients in whom <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> was unsuccessful were excluded from analysis. The baseline <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content> before C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> was significantly higher (<jats:italic>P<\/jats:italic> &lt; 0\u00b701) in patients with <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> than in those with <jats:styled-content style=\"fixed-case\">EH<\/jats:styled-content>. However, the degree of difference in <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content> between patients with <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EH<\/jats:styled-content> was not enhanced by the administration of cosyntropin. In addition, the administration of cosyntropin did not improve the distinction between bilateral and unilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>C\u2010<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> has no utility as a confirmatory and subtype testing of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> when the diagnosis of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> is based on the positive results in <jats:styled-content style=\"fixed-case\">SIT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13167","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T11:32:32Z","timestamp":1472729552000},"page":"170-176","source":"Crossref","is-referenced-by-count":4,"title":["Reassessment of the cosyntropin stimulation test in the confirmatory diagnosis and subtype 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