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There has been speculation that two types of drugs used to treat high blood pressure and heart failure – angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers ( ARA) – may increase the risk of getting COVID-19[feminine.
Les chercheurs ont examiné les bases de données MEDLINE et EMBASE pour des études qui détaillaient les patients traités avec des inhibiteurs de l’ECA et / ou des médicaments ARB. Ils ont mené deux méta-analyses pour évaluer les résultats de 17 essais: 1) pour enquêter sur le taux de cas positifs au COVID-19 et 2) pour déterminer le taux de mortalité parmi les personnes hospitalisées pour COVID-19.
Leurs analyses ont abouti à ces résultats:
- Les patients prenant des inhibiteurs de l’ECA ou des ARA n’ont pas eu de taux accru d’infection au COVID-19; et
- Les patients hospitalisés sous COVID-19 prenant des inhibiteurs de l’ECA ou des ARA n’ont pas augmenté le taux de mortalité.
Une sous-analyse a également été réalisée, centrée sur les études incluant des patients traités pour hypertension. Les résultats indiquent que la prise d’inhibiteurs de l’ECA et d’ARB était associée à un taux de mortalité plus faible chez les patients hospitalisés COVID-19 ayant des antécédents d’hypertension.
“The results of our study confirm that patients already taking ACE inhibitors and ARBs should not stop taking them due to COVID-19 infection,” said lead author of the study. Yujiro Yokoyama, MD, surgeon at Easton Hospital at St. Luke’s University Health Network in Pennsylvania. “Both drugs have proven to be beneficial for heart and kidney disease, further confirming previous findings that ACE inhibitors do not pose an additional risk with COVID-19.”
At the start of the COVID-19 pandemic, the American Heart Association released a joint statement with the Heart Failure Society of America and the American College of Cardiology to address the use of ACE inhibitors and ARB drugs. in patients at risk of developing COVID-19. The recommendations called for continuation of the ACE-i or ARB drugs in patients already taking them for indications such as heart failure, hypertension or ischemic heart disease. Patients with cardiovascular disease who are diagnosed with COVID-19 should be fully evaluated before adding or removing treatments, and any changes to their treatment should be based on the latest scientific evidence and shared decision-making with their doctor and their health care team.
Meta-analyzes of the effect of inhibitors of the renin-angiotensin-aldosterone system on mortality and positive test for Covid-19 (presentation 399)
The co-authors of the study are Hisato Takagi, MD, Ph.D .; Tadao Aikawa, MD, Ph.D .; and Toshiki Kuno, MD, Ph.D. The authors’ disclosures are detailed in the abstract. No external funding source was identified for this study.
Note: Session: CV19.AOS.848 – COVID-19: Risk Scores and Risk Factors for Adverse Reactions
As the COVID-19 pandemic continues to affect people around the world, research is underway to facilitate a better understanding of the virus in order to improve patient care and outcomes. Heart health and medications and the potential role each has on COVID-19 patients has been the subject of hundreds of studies. The American Heart Association will host experts presenting the latest research on COVID-19 at its 2020 Scientific Sessions. The meeting will be held virtually from Friday, November 13 to Tuesday, November 17, 2020 and is a leading global exchange on the latest advances. scientists. , research and updates on evidence-based clinical practice in cardiovascular science for healthcare worldwide.
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