Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19

DOI Web Site 被引用文献6件
  • Peng Zhang
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Lihua Zhu
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Jingjing Cai
    Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J. Cai)
  • Fang Lei
    Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
  • Juan-Juan Qin
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Jing Xie
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Ye-Mao Liu
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Yan-Ci Zhao
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Xuewei Huang
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Lijin Lin
    Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
  • Meng Xia
    Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
  • Ming-Ming Chen
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Xu Cheng
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Xiao Zhang
    Eye Center (X.Z.), Renmin Hospital of Wuhan University
  • Deliang Guo
    Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
  • Yuanyuan Peng
    Cardiology (Y.P.), Zhongnan Hospital of Wuhan University
  • Yan-Xiao Ji
    Medical Science Research Center (P.Z., Y.-X.J., H.L.), Zhongnan Hospital of Wuhan University
  • Jing Chen
    Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.)
  • Zhi-Gang She
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Yibin Wang
    Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.)
  • Qingbo Xu
    Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.)
  • Renfu Tan
    Wuhan Kanghuashuhai Technology Company (R.T.), Wuhan
  • Haitao Wang
    Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
  • Jun Lin
    Gastroenterology (J.L.), Zhongnan Hospital of Wuhan University
  • Pengcheng Luo
    Urology (P.L.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
  • Shouzhi Fu
    Intensive Care Unit (S.F.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
  • Hongbin Cai
    Wuhan Ninth Hospital (H.C., M.L.)
  • Ping Ye
    Cardiology, The Central Hospital of Wuhan (P.Y., M.C.)
  • Bing Xiao
    Stomatology, Xiantao First People’s Hospital (B.X.)
  • Weiming Mao
    General Surgery, Huanggang Central Hospital, Wuhan, China (W.M.)
  • Liming Liu
    General Surgery, Ezhou Central Hospital (L. Liu)
  • Youqin Yan
    Infections Department, Wuhan Seventh Hospital (Y. Yan)
  • Mingyu Liu
    Wuhan Ninth Hospital (H.C., M.L.)
  • Manhua Chen
    Cardiology, The Central Hospital of Wuhan (P.Y., M.C.)
  • Xiao-Jing Zhang
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University
  • Xinghuan Wang
    Center for Evidence-Based and Translational Medicine (X.W.), Zhongnan Hospital of Wuhan University
  • Rhian M. Touyz
    Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (R.M.T.)
  • Jiahong Xia
    Cardiovascular Surgery, Union Hospital (J.Xia), Tongji Medical College, Huazhong University of Science and Technology
  • Bing-Hong Zhang
    Neonatology (B.-H.Z.), Renmin Hospital of Wuhan University
  • Xiaodong Huang
    Gastroenterology (X.H.), Wuhan Third Hospital & Tongren Hospital of Wuhan University
  • Yufeng Yuan
    Hepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University
  • Rohit Loomba
    NAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California San Diego, CA (R.L.)
  • Peter P. Liu
    Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (P.P.L.).
  • Hongliang Li
    From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University

抄録

<jats:sec> <jats:title>Rationale:</jats:title> <jats:p>Use of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective:</jats:title> <jats:p>To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in patients with hypertension and hospitalized due to COVID-19.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results:</jats:title> <jats:p> This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [interquartile range, 55–68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [interquartile range 57–69]; 53.5% men), who were admitted to 9 hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted hazard ratio, 0.42 [95% CI, 0.19–0.92]; <jats:italic>P</jats:italic> =0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted hazard ratio, 0.37 [95% CI, 0.15–0.89]; <jats:italic>P</jats:italic> =0.03). Further subgroup propensity score-matched analysis indicated that, compared with use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted hazard ratio, 0.30 [95% CI, 0.12–0.70]; <jats:italic>P</jats:italic> =0.01) in patients with COVID-19 and coexisting hypertension. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Among hospitalized patients with COVID-19 and coexisting hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB nonusers. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk.</jats:p> </jats:sec>

収録刊行物

  • Circulation Research

    Circulation Research 126 (12), 1671-1681, 2020-06-05

    Ovid Technologies (Wolters Kluwer Health)

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