scholarly journals Beneficial Effects of Combination Therapy with Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor on Vascular Endothelial Function

2008 ◽  
Vol 31 (8) ◽  
pp. 1603-1610 ◽  
Author(s):  
Satoshi MORIMOTO ◽  
Kei MAKI ◽  
Yasuko AOTA ◽  
Takao SAKUMA ◽  
Toshiji IWASAKA
Keyword(s):  
Angiotensin Ii ◽  
Combination Therapy ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Angiotensin Ii Receptor Blocker ◽  
Vascular Endothelial ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Vascular Endothelial Function ◽  
Beneficial Effects

scholarly journals Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244532
Author(s):  
Rodrigo A. Brandão Neto ◽  
Julio F. Marchini ◽  
Lucas O. Marino ◽  
Julio C. G. Alencar ◽  
Felippe Lazar Neto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Multivariate Analysis ◽  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Angiotensin Ii Receptor Blocker ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
All Cause Mortality

Background The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients. Methods From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others. Results From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality Conclusions This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies. Trial registration The study was registered in the Brazilian registry of clinical trials: RBR-5d4dj5.

scholarly journals Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive COVID-19 Patients Is Associated With Positive Clinical Outcome

2020 ◽  
Vol 222 (8) ◽  
pp. 1256-1264 ◽  
Author(s):  
Katherine W Lam ◽  
Kenneth W Chow ◽  
Jonathan Vo ◽  
Wei Hou ◽  
Haifang Li ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Odds Ratio ◽  
Enzyme Inhibitor ◽  
Laboratory Data ◽  
Admission Rate ◽  
Angiotensin Ii Receptor Blocker ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Icu Admission

Abstract Background This study investigated continued and discontinued use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) during hospitalization of 614 hypertensive laboratory-confirmed COVID-19 patients. Methods Demographics, comorbidities, vital signs, laboratory data, and ACEi/ARB usage were analyzed. To account for confounders, patients were substratified by whether they developed hypotension and acute kidney injury (AKI) during the index hospitalization. Results Mortality (22% vs 17%, P > .05) and intensive care unit (ICU) admission (26% vs 12%, P > .05) rates were not significantly different between non-ACEi/ARB and ACEi/ARB groups. However, patients who continued ACEi/ARBs in the hospital had a markedly lower ICU admission rate (12% vs 26%; P = .001; odds ratio [OR] = 0.347; 95% confidence interval [CI], .187–.643) and mortality rate (6% vs 28%; P = .001; OR = 0.215; 95% CI, .101–.455) compared to patients who discontinued ACEi/ARB. The odds ratio for mortality remained significantly lower after accounting for development of hypotension or AKI. Conclusions These findings suggest that continued ACEi/ARB use in hypertensive COVID-19 patients yields better clinical outcomes.

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