Outcomes
Primary outcome measures were assessed at 6 months post-surgery or after 9–12 months of medical therapy. The primary objective of MATCH was to compare the accuracy of MTO and AVS in diagnosing unilateral PA, by measuring normalization of biochemical and clinical parameters following adrenalectomy. The criteria for normalization were the PASO criteria, agreed by international consensus in 2017 (Supplementary Table Secondary objectives of MATCH included serial measurements, up to 2 years post-intervention, of the criteria for assessing biochemical and clinical success, analyzed separately in the surgically and medically treated participants, and analyses of parameters that may, in the future, enable more reliable prediction of which patients can achieve complete clinical success post-adrenalectomy. The main clinical test was a within-trial measurement of participants’ responses to 4 weeks of treatment with spironolactone. Molecular analyses included RNA-seq of APAs for genotyping and transcriptomics. We also report the left ventricular mass and end diastolic volume measurements from the CMR sub-study of 50 patients, performed at baseline and 1 year after surgical or medical management.