The SPARTACUS Trial: Controversies and Unresolved Issues

DOI PDF 被引用文献2件
  • Felix Beuschlein
    Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU, Munich, Germany
  • Paolo Mulatero
    Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Torino, Italy
  • Evelyn Asbach
    Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU, Munich, Germany
  • Silvia Monticone
    Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Torino, Italy
  • Cristiana Catena
    Clinica Medica and Chair of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy
  • Leonardo Sechi
    Clinica Medica and Chair of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy
  • Michael Stowasser
    Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia

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<jats:title>Abstract</jats:title><jats:p>Adrenal vein sampling (AVS) is considered the gold standard for the differential diagnosis in patients with primary aldosteronism (PA). The distinction between unilateral and bilateral disease dictates the targeted therapeutic approach with surgery for aldosterone producing adenomas and medical therapy for patients with bilateral hyperplasia. Thereby, this diagnostic step is crucial in clinical care. As AVS is an invasive, not well standardized procedure that is restricted to few specialized centers, several attempts have been made to simplify diagnostic algorithms. In this clinical scenario, the recently published SPARTACUS trial aimed at answering the question whether AVS in fact is superior for differential diagnosis in comparison to imaging of the adrenal glands. In this multicenter study, patients were randomized to be treated according to AVS results or based on abdominal imaging only. Clinical outcome in both patient groups after one year was reported as not different. While the study results found broad interest, it also stirred considerable controversies. This review provides an overview on the different views regarding the outline of the SPARTACUS trial and the interpretation of its results.</jats:p>

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