New quick cortisol assay during adrenal vein sampling in patients with primary aldosteronism

T. Yoneda; S. Karashima; M. Demura; N. Oda; S. Mori; M. Kometani; O. Masashi; A. Hashimoto; T. Sawamura; M. Yamagishi; Y. Takeda

Background: Adrenal vein sampling (AVS) is the gold standard test for identification of unilateral primary aldosteronism (PA) which is curable by surgery, but is a difficult procedure with low success rates. Rapid cortisol assays during AVS improved AVS success rates.

Methods: We have developed a gold nanoparticles based immunochromatographic quick cortisol assay (QCA) in which cortisol concentration could be measured both quantitatively and semi-quantitatively within 6 minutes. We performed a prospective randomized controlled study to evaluate the success rate of AVS incorporating our new QCAs at Kanazawa University Hospital. Ninety PA patients were randomly assigned to undergo AVS using quantitative QCA (quantitative QCA group, n=30), AVS using semi-quantitative QCA (semi-quantitative QCA group, n=30) or AVS without QCA (control group, n=30). We next evaluated the usefulness of semi-quantitative QCA at 4 centers: Kanazawa University Hospital and 3 centers with initial low AVS success rates. We randomly assigned 151 PA patients to undergo AVS using semi-quantitative QCA (semi-quantitative QCA group, n=77) or AVS without QCA (control group, n=74).

Results: AVS success rate in the quantitative QCA group (28 of 30 (93%)) did not differ from that in the semi-quantitative QCA group (28 of 30 (93%)), which were significantly higher than that in the control group (21 of 30 (70%)). The total AVS success rate in the semi- quantitative QCA group at 4 centers was 71 of 77 (92%), significantly higher than that in control group (43 of 74 (58%). Even at 3 centers with initial low AVS success rates, the AVS success rate in the semi-quantitative QCA group was 39 of 43(91%), significantly higher than that in control group (21 of 43 (49%).

Conclusions: Our new quick cortisol assay was very fast, simple, and easy and was proved to improve the AVS success rates.

Declaration of interest: I fully declare a conflict of interest. Details below.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector

Endocrine Abstracts

P69