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Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemic
G. De Luca, M. Nardin, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, LO. Jensen, PH. Loh, L. Calmac, G. Roura Ferrer, A. Quadros, M. Milewski, F. Scotto di Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G. Casella,...
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články
- Publikační typ
- časopisecké články MeSH
Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment. Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients. Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p < 0.0001), consistently both in 2019 and in 2010. Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both pre-admission chronic RASI therapy and in-hospital RASI did not negatively affected patients' survival during the hospitalization, neither increased the risk of SARS-CoV2 infection. Trial registration number: NCT04412655.
3rd Medicine Division Department of Internal Medicine ASST Spedali Civili Brescia Italy
Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste Italy
Azienda Ospedaliero Universitaria Sassari Italy
Cardiology Division Department of Internal Medicine National Taiwan University Hospital Tapei Taiwan
Cardiology Institute Instanbul University Instanbul Turkey
Carlos E Uribe Division of Cardiology Universidad UPB Universidad CES Medellin Colombia
Center for Cardiovascular Diseases Ohrid North Macedonia
Center Hospitalier d'Antibes Juan Les Pins Antibes France
Central Hospital of Medical University of Lodz Poland
Centre for Intensive Internal Medicine University Medical Centre Ljubljana Slovenia
Clinic Emergency Hospital of Bucharest Romania
Complexo Hospetaliero Universitario La Coruna La Coruna Spain
Department of Cardiology Hospital Bezmialem Vakıf University İstanbul Turkey
Department of Cardiology National Heart Center Singapore
Department of Cardiology National University Hospital Singapore
Department of Cardiology Queen Elizabeth Hospital University of Hong Kong Hong Kong
Department of Cardiology Queen Mary Hospital University of Hong Kong Hong Kong
Department of Cardiology Thoraxcentrum Twente Medisch Spectrum Twente Enschede the Netherlands
Department of Cardiology University Hospital Centre University of Zagreb Zagreb Croatia
Department of Statistical Sciences University of Padova Italy
Department of Teaching and Research Instituto de Cardiología de Corrientes Argentina
Division of Cardiology Alexandra Hospital Athens Greece
Division of Cardiology Assiut University Heart Hospital Assiut University Asyut Egypt
Division of Cardiology Attikon University Hospital Athens Greece
Division of Cardiology AUSL IRCCS Reggio Emilia Italy
Division of Cardiology Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
Division of cardiology Blida University Hospital Blida Algeria
Division of Cardiology Bursa City Hospital Bursa Turkey
Division of Cardiology Center Hospitalier Universitaire de Lille Lille France
Division of Cardiology CHU Lariboisière AP HP Paris 7 University INSERM UMRS 942 France
Division of Cardiology Clinica Villa dei Fiori Acerra Italy
Division of Cardiology ComplejoHospitalario de Toledo Toledo Spain
Division of Cardiology Faculty of Medicine Eskisehir Osmangazi University Eskisehir Turkey
Division of Cardiology Groupe Hospitalier Mutualiste de Grenoble France
Division of Cardiology Heart Centre Turku Finland
Division of Cardiology Hopital Erasmus Universitè Libre de Bruxelles Belgium
Division of Cardiology Hospiatl Cordoba Cordoba Argentina
Division of Cardiology Hospital Cabueñes Gijon Spain
Division of Cardiology Hospital Clinico Universitario de Valencia Spain
Division of Cardiology Hospital de Santa Cruz CHLO Nova Medical School CEDOC Lisbon Portugal
Division of Cardiology Hospital de Santo António Porto Portugal
Division of Cardiology Hospital Puerta de Hierro Majadahonda Spain
Division of Cardiology Hospital Puerta del Mar Cadiz Spain
Division of cardiology Hospital Universitario de Canarias Santa Cruz de Tenerife Spain
Division of Cardiology Kontantopoulion Hospital Athens Greece
Division of Cardiology Medical University of Silezia Katowice Poland
Division of Cardiology Northwest Clinics Alkmaar The Netherlands
Division of Cardiology Odense Universitets Hospital Odense Danemark
Division of Cardiology Ospedale A Manzoni Lecco Italy
Division of Cardiology Ospedale Civico Arnas Palermo Italy
Division of Cardiology Ospedale degli Infermi ASL Biella Italy
Division of Cardiology Ospedale del Mare Napoli Italy
Division of Cardiology Ospedale F Spaziani Frosinone Italy
Division of Cardiology Ospedale G Moscati Aversa Italy
Division of Cardiology Ospedale Maggiore Bologna Italy
Division of Cardiology Ospedale S Maurizio Bolzano Italy
Division of Cardiology Ospedale San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
Division of Cardiology Ospedale Sant'Anna Ferrara Italy
Division of Cardiology Ospedale Santa Chiara di Trento Italy
Division of Cardiology Ospedale Santa Maria delle Grazie Pozzuoli Italy
Division of Cardiology Ospedale Santa Maria Goretti Latina Italy
Division of Cardiology Otamendi Hospital Buenos Aires Argentina
Division of Cardiology Oulu University Hospital Finland
Division of Cardiology Radboud University Medical Center Nijmegen the Netherlands
Division of Cardiology St Antonius Hospital Nieuwegein The Netherlands
Division of Cardiology UMC Utrecht the Netherlands
Hospital Clínico Universitario Virgen de la Victoria Málaga Spain
Hospital Garcia de Orta Cardiology Department Pragal Almada HP Portugal
Hospital Germans Triasi Pujol Badalona Spain
Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina
Instituto de Cardiologia de Santa Catarina Praia Comprida São José Brasil
Instituto de Cardiologia do Rio Grande do Sul Porto Alegre Brazil
Instituto de Cardiologia Integral Montevideo Uruguay
Interventional Cardiology Unit Azienda Ospedaliera Sanitaria Parma Italy
Interventional Cardiology Unit Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona Italy
Interventional Cardiology Unit Heart Disease Institute Hospital Universitari de Bellvitge Spain
Invasive Cardiology and Congenital Heart Disease Patras University Hospital Patras Greece
Iraklion University Hospital Crete Greece
Maastricht University Medical Center the Netherlands
Tyumen Cardiology Research Center Russia
Universitario y Politécnico La Fe Valencia Spain
University Hospital Brno Medical Faculty of Masaryk University Brno Czech Republic
Citace poskytuje Crossref.org
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- $a De Luca, Giuseppe $u Cardiology, Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Italy
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- $a Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemic / $c G. De Luca, M. Nardin, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, LO. Jensen, PH. Loh, L. Calmac, G. Roura Ferrer, A. Quadros, M. Milewski, F. Scotto di Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G. Casella, AWS. Lung, P. Kala, JL. Díez Gil, X. Carrillo, M. Dirksen, VM. Becerra-Munoz, MK. Lee, DA. Juzar, R. de Moura Joaquim, R. Paladino, D. Milicic, P. Davlouros, N. Bakraceski, F. Zilio, L. Donazzan, A. Kraaijeveld, G. Galasso, A. Lux, L. Marinucci, V. Guiducci, M. Menichelli, A. Scoccia, AH. Yamac, KU. Mert, X. Flores Rios, T. Kovarnik, M. Kidawa, J. Moreu, V. Flavien, E. Fabris, IL. Martínez-Luengas, M. Boccalatte, F. Bosa Ojeda, C. Arellano-Serrano, G. Caiazzo, G. Cirrincione, HL. Kao, J. Sanchis Forés, L. Vignali, H. Pereira, S. Manzo, S. Ordoñez, A. Arat Özkan, B. Scheller, H. Lehtola, R. Teles, C. Mantis, Y. Antti, JA. Brum Silveira, R. Zoni, I. Bessonov, S. Savonitto, G. Kochiadakis, D. Alexopulos, CE. Uribe, J. Kanakakis, B. Faurie, G. Gabrielli, A. Gutierrez Barrios, JP. Bachini, A. Rocha, FC. Tam, A. Rodriguez, AA. Lukito, V. Saint-Joy, G. Pessah, A. Tuccillo, G. Cortese, G. Parodi, MA. Bouraghda, E. Kedhi, P. Lamelas, H. Suryapranata, M. Verdoia
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- $a Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment. Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients. Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p < 0.0001), consistently both in 2019 and in 2010. Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both pre-admission chronic RASI therapy and in-hospital RASI did not negatively affected patients' survival during the hospitalization, neither increased the risk of SARS-CoV2 infection. Trial registration number: NCT04412655.
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