학술논문

Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemic
Document Type
article
Author
Giuseppe De LucaMatteo NardinMagdy AlgowharyBerat UguzDinaldo C OliveiraVladimir GanyukovZan ZimbakovMiha CercekLisette Okkels JensenPoay Huan LOHLucian CalmacGerard Roura FerrerAlexandre QuadrosMarek MilewskiFortunato Scotto di UccioClemens von BirgelenFrancesco VersaciJurrien Ten BergGianni CasellaAaron Wong Sung LungPetr KalaJosé Luis Díez GilXavier CarrilloMaurits DirksenVictor M. Becerra-MunozMichael Kang-yin LeeDafsah Arifa JuzarRodrigo de Moura JoaquimRoberto PaladinoDavor MilicicPeriklis DavlourosNikola BakraceskiFilippo ZilioLuca DonazzanAdriaan KraaijeveldGennaro GalassoArpad LuxLucia MarinucciVincenzo GuiducciMaurizio MenichelliAlessandra ScocciaAylin Hatice YamacKadir Ugur MertXacobe Flores RiosTomas KovarnikMichal KidawaJosè MoreuVincent FlavienEnrico FabrisIñigo Lozano Martínez-LuengasMarco BoccalatteFrancisco Bosa OjedaCarlos Arellano-SerranoGianluca CaiazzoGiuseppe CirrincioneHsien-Li KaoJuan Sanchis ForésLuigi VignaliHelder PereiraStephane ManzoSantiago OrdoñezAlev Arat ÖzkanBruno SchellerHeidi LehtolaRui TelesChristos MantisYlitalo AnttiJoão António Brum SilveiraRodrigo ZoniIvan BessonovStefano SavonittoGeorge KochiadakisDimitrios AlexopulosCarlos E UribeJohn KanakakisBenjamin FaurieGabriele GabrielliAlejandro Gutierrez BarriosJuan Pablo BachiniAlex RochaFrankie Chor-Cheung TamAlfredo RodriguezAntonia Anna LukitoVeauthyelau Saint-JoyGustavo PessahAndrea TuccilloGiuliana CorteseGuido ParodiMohammed Abed BouraghdaElvin KedhiPablo LamelasHarry SuryapranataMonica Verdoia
Source
Diabetes Epidemiology and Management, Vol 4, Iss , Pp 100022- (2021)
Subject
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Language
English
ISSN
2666-9706
Abstract
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