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Title: | Impact of renin-angiotensin system inhibitors on mortality during the COVID Pandemic among STEMI patients undergoing mechanical reperfusion: Insight from an international STEMI registry |
Author: | Luca, Giuseppe De 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, Michał Marinucci, Lucia Zilio, Filippo Galasso, Gennaro Fabris, Enrico Menichelli, Maurizio Manzo, Stephane Caiazzo, Gianluca Moreu, José Sanchis Forés, Juan Donazzan, Luca Vignali, Luigi Teles, Rui Agostoni, Pierfrancesco Bosa Ojeda, Francisco Lehtola, Heidi Camacho-freiere, Santiago Kraaijeveld, Adriaan Antti, Ylitalo Visconti, Gabriella Lozano Martínez-Luengas, Iñigo Scheller, Bruno Alexopulos, Dimitrios Moreno, Raúl Kedhi, Elvin Uccello, Giuseppe Faurie, Benjamin Gutierrez Barrios, Alejandro Scotto Di Uccio, Fortunato Wilbert, Bor Cortese, Giuliana Dirksen, Maurits T. Parodi, Guido Verdoia, Monica |
Keywords: | COVID-19 Mortalitat COVID-19 |
Issue Date: | 1-May-2021 |
Publisher: | Elsevier B. V. |
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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1016/j.biopha.2021.111469 |
It is part of: | Biomedicine & Pharmacotherapy, 2021, vol. 138 |
URI: | http://hdl.handle.net/2445/177570 |
Related resource: | https://doi.org/10.1016/j.biopha.2021.111469 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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