Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and COVID-19-related outcomes: A patient-level analysis of the PCORnet blood pressure control lab.
Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and COVID-19-related outcomes: A patient-level analysis of the PCORnet blood pressure control lab.
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DOI：
10.1016/j.ahjo.2022.100112
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Cooper-DeHoff RM
中科院分区：
文献类型：
--
作者：
Smith SM;Desai RA;Walsh MG;Nilles EK;Shaw K;Smith M;Chamberlain AM;Derington CG;Bress AP;Chuang CH;Ford DE;Taylor BW;Chandaka S;Patel LP;McClay J;Priest E;Fuloria J;Doshi K;Ahmad FS;Viera AJ;Faulkner M;O'Brien EC;Pletcher MJ;Cooper-DeHoff RM
SARS-CoV-2通过血管紧张素转换酶-2进入宿主细胞，而血管紧张素转换酶-2也受到常用的血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARB）的影响，这引发了人们对ACEI或ARB暴露可能预示着不同的COVID-19结果的担忧。在门诊和住院COVID-19诊断的高血压成人的平行队列研究中，我们使用PCORnet卫生系统的电子健康记录数据，评估了COVID-19诊断时抗高血压药物暴露（ACEI/ARB与非ACEI/ARB抗高血压药物，以及ACEI与ARB之间）之间的相关性。主要结局为全因住院或死亡（门诊队列）或全因死亡（住院），通过治疗权重的逆概率加权的考克斯回归分析。从2020年2月至2020年12月9日，11，246例患者（3477人-年）和2200例患者（777人-年）分别来自17个卫生系统的门诊和住院队列。在门诊队列中有1015例全因住院或死亡（发生率，29.2例事件/100人-年），ACEI/ARB使用无显著差异（校正HR 1.01; 95% CI 0.88，1.15）。在住院队列中，有218例全因死亡（发生率，28.1/100人-年），ACEI/ARB暴露与死亡减少相关（校正HR，0.76; 95%CI，0.57，0.99）。与ARB暴露相比，ACEI与门诊队列中较高的住院风险相关，但两个队列中的全因死亡率无差异。在预先规定的基线特征中，无效应改变的证据。我们的研究结果表明，ACEI和ARB暴露对住院治疗没有不利影响，并可能降低确诊为COVID-19的高血压患者的死亡率。
SARS-CoV-2 accesses host cells via angiotensin-converting enzyme-2, which is also affected by commonly used angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), raising concerns that ACEI or ARB exposure may portend differential COVID-19 outcomes. In parallel cohort studies of outpatient and inpatient COVID-19-diagnosed adults with hypertension, we assessed associations between antihypertensive exposure (ACEI/ARB vs. non-ACEI/ARB antihypertensives, as well as between ACEI- vs. ARB) at the time of COVID-19 diagnosis, using electronic health record data from PCORnet health systems. The primary outcomes were all-cause hospitalization or death (outpatient cohort) or all-cause death (inpatient), analyzed via Cox regression weighted by inverse probability of treatment weights. From February 2020 through December 9, 2020, 11,246 patients (3477 person-years) and 2200 patients (777 person-years) were included from 17 health systems in outpatient and inpatient cohorts, respectively. There were 1015 all-cause hospitalization or deaths in the outpatient cohort (incidence, 29.2 events per 100 person-years), with no significant difference by ACEI/ARB use (adjusted HR 1.01; 95% CI 0.88, 1.15). In the inpatient cohort, there were 218 all-cause deaths (incidence, 28.1 per 100 person-years) and ACEI/ARB exposure was associated with reduced death (adjusted HR, 0.76; 95% CI, 0.57, 0.99). ACEI, versus ARB exposure, was associated with higher risk of hospitalization in the outpatient cohort, but no difference in all-cause death in either cohort. There was no evidence of effect modification across pre-specified baseline characteristics. Our results suggest ACEI and ARB exposure have no detrimental effect on hospitalizations and may reduce death among hypertensive patients diagnosed with COVID-19.
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影响因子：
4.9
作者：
Cohen JB;D'Agostino McGowan L;Jensen ET;Rigdon J;South AM
通讯作者：
South AM
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影响因子：
3.7
作者：
Derington CG;Cohen JB;Mohanty AF;Greene TH;Cook J;Ying J;Wei G;Herrick JS;Stevens VW;Jones BE;Wang L;Zheutlin AR;South AM;Hanff TC;Smith SM;Cooper-DeHoff RM;King JB;Alexander GC;Berlowitz DR;Ahmad FS;Penrod MJ;Hess R;Conroy MB;Fang JC;Rubin MA;Beddhu S;Cheung AK;Xian W;Weintraub WS;Bress AP
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Bress AP
DOI：
10.1016/s2213-2600(20)30558-0
发表时间：
2021-03
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Cohen JB;Hanff TC;William P;Sweitzer N;Rosado-Santander NR;Medina C;Rodriguez-Mori JE;Renna N;Chang TI;Corrales-Medina V;Andrade-Villanueva JF;Barbagelata A;Cristodulo-Cortez R;Díaz-Cucho OA;Spaak J;Alfonso CE;Valdivia-Vega R;Villavicencio-Carranza M;Ayala-García RJ;Castro-Callirgos CA;González-Hernández LA;Bernales-Salas EF;Coacalla-Guerra JC;Salinas-Herrera CD;Nicolosi L;Basconcel M;Byrd JB;Sharkoski T;Bendezú-Huasasquiche LE;Chittams J;Edmonston DL;Vasquez CR;Chirinos JA
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Chirinos JA
影响因子：
4.9
作者：
Tse, Gary;Zhou, Jiandong;Zhang, Qingpeng
通讯作者：
Zhang, Qingpeng
影响因子：
4.9
作者：
Bavishi C;Whelton PK;Mancia G;Corrao G;Messerli FH
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