1. Renin-Angiotensin System inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID Pandemic
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Giuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uguz, Dinaldo C Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan LOH, Lucian Calmac, Gerard Roura Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M. Becerra-Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Arpad Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, Carlos E Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohammed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Monica Verdoia, De Luca, Giuseppe, Nardin, Matteo, Algowhary, Magdy, Uguz, Berat, Oliveira, Dinaldo C, Ganyukov, Vladimir, Zimbakov, Zan, Cercek, Miha, Jensen, Lisette Okkel, Loh, Poay Huan, Calmac, Lucian, Roura Ferrer, Gerard, Quadros, Alexandre, Milewski, Marek, Scotto di Uccio, Fortunato, von Birgelen, Clemen, Versaci, Francesco, Ten Berg, Jurrien, Casella, Gianni, Lung, Aaron Wong Sung, Kala, Petr, Díez Gil, José Lui, Carrillo, Xavier, Dirksen, Maurit, Becerra-Munoz, Victor M, Lee, Michael Kang-Yin, Juzar, Dafsah Arifa, de Moura Joaquim, Rodrigo, Paladino, Roberto, Milicic, Davor, Davlouros, Perikli, Bakraceski, Nikola, Zilio, Filippo, Donazzan, Luca, Kraaijeveld, Adriaan, Galasso, Gennaro, Lux, Arpad, Marinucci, Lucia, Guiducci, Vincenzo, Menichelli, Maurizio, Scoccia, Alessandra, Yamac, Aylin Hatice, Mert, Kadir Ugur, Flores Rios, Xacobe, Kovarnik, Toma, Kidawa, Michal, Moreu, Josè, Flavien, Vincent, Fabris, Enrico, Martínez-Luengas, Iñigo Lozano, Boccalatte, Marco, Bosa Ojeda, Francisco, Arellano-Serrano, Carlo, Caiazzo, Gianluca, Cirrincione, Giuseppe, Kao, Hsien-Li, Sanchis Forés, Juan, Vignali, Luigi, Pereira, Helder, Manzo, Stephane, Ordoñez, Santiago, Arat Özkan, Alev, Scheller, Bruno, Lehtola, Heidi, Teles, Rui, Mantis, Christo, Antti, Ylitalo, Brum Silveira, João António, Zoni, Rodrigo, Bessonov, Ivan, Savonitto, Stefano, Kochiadakis, George, Alexopulos, Dimitrio, Uribe, Carlos E, Kanakakis, John, Faurie, Benjamin, Gabrielli, Gabriele, Gutierrez Barrios, Alejandro, Bachini, Juan Pablo, Rocha, Alex, Tam, Frankie Chor-Cheung, Rodriguez, Alfredo, Lukito, Antonia Anna, Saint-Joy, Veauthyelau, Pessah, Gustavo, Tuccillo, Andrea, Cortese, Giuliana, Parodi, Guido, Bouraghda, Mohammed Abed, Kedhi, Elvin, Lamelas, Pablo, Suryapranata, Harry, Verdoia, Monica, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Centro de Estudos de Doenças Crónicas (CEDOC)
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Renin-angiotensin system inhibitors ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,COVID-19 ,030204 cardiovascular system & hematology ,STEMI ,RC648-665 ,Diseases of the endocrine glands. Clinical endocrinology ,Article ,Renin-angiotensin system inhibitor ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,SDG 3 - Good Health and Well-being ,030220 oncology & carcinogenesis ,Internal medicine ,Pandemic ,Renin–angiotensin system ,Internal Medicine ,Cardiology ,Medicine ,business - 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 < 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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- 2021
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