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Impact of renin-angiotensin system inhibitors on mortality during the COVID Pandemic among STEMI patients undergoing mechanical reperfusion: Insight from an international STEMI registry.
De Luca, Giuseppe; Cercek, Miha; Okkels Jensen, Lisette; Bushljetikj, Oliver; Calmac, Lucian; Johnson, Tom; Gracida Blancas, Montserrat; Ganyukov, Vladimir; Wojakowski, Wojtek; von Birgelen, Clemens; IJsselmuiden, Alexander; Tuccillo, Bernardo; Versaci, Francesco; Ten Berg, Jurrien; Laine, Mika; Berkout, Tim; Casella, Gianni; Kala, Petr; López Ledesma, Bernabé; Becerra, Victor; Padalino, Roberto; Santucci, Andrea; Carrillo, Xavier; Scoccia, Alessandra; Amoroso, Giovanni; Lux, Arpad; Kovarnik, Tomas; Davlouros, Periklis; Gabrielli, Gabriele; Flores Rios, Xacobe; Bakraceski, Nikola; Levesque, Sébastien; Guiducci, Vincenzo; Kidawa, Michal; Marinucci, Lucia; Zilio, Filippo; Galasso, Gennaro; Fabris, Enrico; Menichelli, Maurizio; Manzo, Stephane; Caiazzo, Gianluca; Moreu, Jose; Sanchis Forés, Juan; Donazzan, Luca; Vignali, Luigi; Teles, Rui; Agostoni, Pierfrancesco; Bosa Ojeda, Francisco; Lehtola, Heidi; Camacho-Freiere, Santiago.
  • De Luca G; Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Italy. Electronic address: giuseppe.deluca@med.uniupo.it.
  • Cercek M; Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia.
  • Okkels Jensen L; Division of Cardiology, Odense Universitets Hospital, Odense, Denmark.
  • Bushljetikj O; University Clinic for Cardiology, Medical Faculty, Ss' Cyril and Methodius University, Skopje, North Macedonia.
  • Calmac L; Clinic Emergency Hospital of Bucharest, Romania.
  • Johnson T; Division of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHSFT & University of Bristol, Bristol.
  • Gracida Blancas M; Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, Spain.
  • Ganyukov V; Division of Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Kemerovo, Russia.
  • Wojakowski W; Division of Cardiology, Medical University of Silezia, Katowice, Poland.
  • von Birgelen C; Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands.
  • IJsselmuiden A; Division of Cardiology, Amphia Hospital, Breda, The Netherlands.
  • Tuccillo B; Division of Cardiology, Ospedale del Mare, Napoli, Italy.
  • Versaci F; Division of Cardiology, Ospedale Santa Maria Goretti Latina, Italy.
  • Ten Berg J; Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
  • Laine M; Division of Cardiology, Helsinki University Central Hospital, Finland.
  • Berkout T; Division of Cardiology, Northwest Clinics Alkmaar, The Netherlands.
  • Casella G; Division of Cardiology, Ospedale Maggiore Bologna, Italy.
  • Kala P; University Hospital Brno, Medical Faculty of Masaryk University Brno, Czech Republic.
  • López Ledesma B; H. Universitario y Politécnico La Fe, Valencia, Spain.
  • Becerra V; Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain.
  • Padalino R; Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy.
  • Santucci A; Ospedale Santa Maria della Misericordia, Perugia, Italy.
  • Carrillo X; Hospital Germans Triasi Pujol, Badalona, Spain.
  • Scoccia A; Division of Cardiology, Ospedale "Sant'Anna", Ferrara, Italy.
  • Amoroso G; Onze Lieve Gasthuis; Amsterdam, The Netherlands.
  • Lux A; Maastricht University Medical Center, The Netherlands.
  • Kovarnik T; University Hospital Prague, Czech Republic.
  • Davlouros P; Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece.
  • Gabrielli G; Interventional Cardiology Unit, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
  • Flores Rios X; Complexo Hospetaliero Universitario La Coruna, La Coruna, Spain.
  • Bakraceski N; Center for Cardiovascular Diseases, Ohrid, North Macedonia.
  • Levesque S; Center Hospitalier Universitaire de Poitiers, Poitiers, University Hospital, Poitiers, France.
  • Guiducci V; AUSL-IRCCS Reggio Emilia, Italy.
  • Kidawa M; Central Hospital of Medical University of Lodz, Poland.
  • Marinucci L; Division of Cardiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy.
  • Zilio F; Ospedale Santa Chiara di Trento, Italy.
  • Galasso G; Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.
  • Fabris E; Azienda Ospedaliero - Universitaria Ospedali Riuniti Trieste, Italy.
  • Menichelli M; Division of Cardiology, Ospedale "F. Spaziani", Frosinone, Italy.
  • Manzo S; Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, France.
  • Caiazzo G; Division of Cardiology, Ospedale "G Moscati", Aversa, Italy.
  • Moreu J; Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain.
  • Sanchis Forés J; Division of Cardiology, Hospital Clinico Universitario de Valencia, Spain.
  • Donazzan L; Division of Cardiology, Ospedale "S. Maurizio" Bolzano Ospedale "S. Maurizio" Bolzano (OR), Italy.
  • Vignali L; Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy.
  • Teles R; Division of Cardiology, Hospital de Santa Cruz, CHLO, Carnaxide, Portugal.
  • Agostoni P; Division of Cardiology, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium.
  • Bosa Ojeda F; Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
  • Lehtola H; Division of Cardiology, Oulu University Hospital, Finland.
  • Camacho-Freiere S; Division of Cardiology, Juan Ramon Jimenez Hospital, Huelva, Spain.
Biomed Pharmacother ; 138: 111469, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1135260
ABSTRACT

BACKGROUND:

Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study.

METHODS:

STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission.

RESULTS:

Our population is represented by 6095 patients, of whom 3654 admitted in 2019 and 2441 in 2020. No difference in the prevalence of SARSCoV2 infection was observed according to RASI therapy at admission (2.5% vs 2.1%, p = 0.5), which was associated with a significantly lower mortality (adjusted OR [95% CI]=0.68 [0.51-0.90], P = 0.006), confirmed in the analysis restricted to 2020 (adjusted OR [95% CI]=0.5[0.33-0.74], P = 0.001). Among the 5388 patients in whom data on in-hospital medication were available, in-hospital RASI therapy was associated with a significantly lower mortality (2.1% vs 16.7%, OR [95% CI]=0.11 [0.084-0.14], p < 0.0001), confirmed after adjustment in both periods. Among the 62 SARSCoV-2 positive patients, RASI therapy, both at admission or in-hospital, showed no prognostic effect.

CONCLUSIONS:

This is the first study to investigate the impact of RASI therapy on the prognosis and SARSCoV2 infection of STEMI patients undergoing PPCI during the COVID-19 pandemic. Both pre-admission and in-hospital RASI were associated with lower mortality. Among SARSCoV2-positive patients, both chronic and in-hospital RASI therapy showed no impact on survival.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Myocardial Reperfusion / ST Elevation Myocardial Infarction / SARS-CoV-2 / COVID-19 / Antihypertensive Agents Type of study: Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Biomed Pharmacother Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Myocardial Reperfusion / ST Elevation Myocardial Infarction / SARS-CoV-2 / COVID-19 / Antihypertensive Agents Type of study: Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Biomed Pharmacother Year: 2021 Document Type: Article