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Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemic

. 2021 Oct-Dec ; 4 () : 100022. [epub] 20211030

Status PubMed-not-MEDLINE Language English Country France Media print-electronic

Document type Journal Article

Links

PubMed 35072135
PubMed Central PMC8556094
DOI 10.1016/j.deman.2021.100022
PII: S2666-9706(21)00022-6
Knihovny.cz E-resources

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 Division of Cardiology Azienda Ospedaliero Universitaria Maggiore della Carità Università del Piemonte Orientale Italy

Cardiology Institute Instanbul University Instanbul Turkey

Cardiovascular Department Pelita Harapan University Heart Center Siloam Lippo Village Hospital Tangerang Banten Indonesia

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 and Cardiovascular Interventions Instituto Nacional de Cirugía Cardíaca Montevideo Uruguay

Department of cardiology and Vascular Medicine University of Indonesia National Cardiovascular Center Harapan Kita Jakarta Indonesia

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 Heart and Vascular Surgery State Research Institute for Complex Issues of Cardiovascular Diseases Kemerovo Russia

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 Clinical and Experimental Interventional Cardiology University of Saarland Germany

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

Medical Faculty Ss' Cyril and Methodius University University Clinic for Cardiology Skopje North Macedonia

Pronto de Socorro Cardiologico Prof Luis Tavares Centro PROCAPE Federal University of Pernambuco Recife Brasil

Tyumen Cardiology Research Center Russia

Universitario y Politécnico La Fe Valencia Spain

University Hospital Brno Medical Faculty of Masaryk University Brno Czech Republic

University Hospital Prague Czech Republic

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