血管紧张素II受体阻滞剂对COVID-19患者死亡率的有益影响:2019 - 2020年中国回顾性研究

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Drugs and Therapy Pub Date : 2025-02-01 Epub Date: 2023-08-11 DOI:10.1007/s10557-023-07494-5
Ke Xu, Wu He, Bo Yu, Kaineng Zhong, Da Zhou, Dao Wen Wang
{"title":"血管紧张素II受体阻滞剂对COVID-19患者死亡率的有益影响:2019 - 2020年中国回顾性研究","authors":"Ke Xu, Wu He, Bo Yu, Kaineng Zhong, Da Zhou, Dao Wen Wang","doi":"10.1007/s10557-023-07494-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has become a serious global public health problem. Although the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) has been recommended in patients with COVID-19 and cardiovascular diseases (CVDs), according to the results of some small-sample retrospective analyses, there remains a lack of sufficient evidence to validate their efficacy. This multicenter retrospective study investigated whether ACEI/ARB administration was beneficial in patients with COVID-19 and CVDs.</p><p><strong>Methods: </strong>A total of 11,231 patients with confirmed COVID-19 and CVDs, from 138 hospitals in Hubei Province, were included in this multicenter retrospective study. We compared the clinical characteristics and outcomes between the ARB and non-ARB groups and analyzed the risk factors for in-hospital death using univariate and multivariate Cox regression analyses and Kaplan-Meier curves.</p><p><strong>Results: </strong>In the multivariate Cox regression model, after adjusting for age, gender, comorbidities, and in-hospital medications, ARB use was associated with lower all-cause mortality (adjusted HR, 0.53; 95% CI, 0.38-0.73; P < 0.001). After propensity score-matched analysis, the adjusted HR for the use of ARB associated with all-cause mortality was 0.62 (95% CI, 0.40-0.88; P = 0.02). Further subgroup analyses found that the adjusted HRs for the use of ARB associated with all-cause mortality were 0.52 (95% CI, 0.30-0.89; P = 0.016), 0.37 (95% CI, 0.21-0.64; P < 0.001), 0.42 (95% CI, 0.28-0.64; P < 0.001), and 0.55 (95% CI, 0.37-0.84; P = 0.005) in patients with heart failure, diabetes, and hypercholesterolemia, and severe COVID-19, respectively.</p><p><strong>Conclusions: </strong>ARB administration was significantly associated with a lower risk of all-cause mortality in patients with COVID-19 and CVDs.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05615792. https://www.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT05615792.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"63-74"},"PeriodicalIF":3.1000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Beneficial Effects of Angiotensin II Receptor Blockers on Mortality in Patients with COVID-19: A Retrospective Study from 2019 to 2020 in China.\",\"authors\":\"Ke Xu, Wu He, Bo Yu, Kaineng Zhong, Da Zhou, Dao Wen Wang\",\"doi\":\"10.1007/s10557-023-07494-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The COVID-19 pandemic has become a serious global public health problem. Although the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) has been recommended in patients with COVID-19 and cardiovascular diseases (CVDs), according to the results of some small-sample retrospective analyses, there remains a lack of sufficient evidence to validate their efficacy. This multicenter retrospective study investigated whether ACEI/ARB administration was beneficial in patients with COVID-19 and CVDs.</p><p><strong>Methods: </strong>A total of 11,231 patients with confirmed COVID-19 and CVDs, from 138 hospitals in Hubei Province, were included in this multicenter retrospective study. We compared the clinical characteristics and outcomes between the ARB and non-ARB groups and analyzed the risk factors for in-hospital death using univariate and multivariate Cox regression analyses and Kaplan-Meier curves.</p><p><strong>Results: </strong>In the multivariate Cox regression model, after adjusting for age, gender, comorbidities, and in-hospital medications, ARB use was associated with lower all-cause mortality (adjusted HR, 0.53; 95% CI, 0.38-0.73; P < 0.001). After propensity score-matched analysis, the adjusted HR for the use of ARB associated with all-cause mortality was 0.62 (95% CI, 0.40-0.88; P = 0.02). Further subgroup analyses found that the adjusted HRs for the use of ARB associated with all-cause mortality were 0.52 (95% CI, 0.30-0.89; P = 0.016), 0.37 (95% CI, 0.21-0.64; P < 0.001), 0.42 (95% CI, 0.28-0.64; P < 0.001), and 0.55 (95% CI, 0.37-0.84; P = 0.005) in patients with heart failure, diabetes, and hypercholesterolemia, and severe COVID-19, respectively.</p><p><strong>Conclusions: </strong>ARB administration was significantly associated with a lower risk of all-cause mortality in patients with COVID-19 and CVDs.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05615792. https://www.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT05615792.</p>\",\"PeriodicalId\":9557,\"journal\":{\"name\":\"Cardiovascular Drugs and Therapy\",\"volume\":\" \",\"pages\":\"63-74\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Drugs and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10557-023-07494-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Drugs and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10557-023-07494-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景:新冠肺炎大流行已成为严重的全球公共卫生问题。尽管血管紧张素转换酶抑制剂(ACEIs)和血管紧张素II受体1型阻滞剂(ARBs)已被推荐用于COVID-19和心血管疾病(cvd)患者,但根据一些小样本回顾性分析的结果,仍然缺乏足够的证据来验证其疗效。这项多中心回顾性研究调查了ACEI/ARB给药对COVID-19和cvd患者是否有益。方法:选取湖北省138家医院确诊的新冠肺炎合并心血管疾病患者11231例进行多中心回顾性研究。我们比较了ARB组和非ARB组的临床特征和结局,并使用单变量和多变量Cox回归分析和Kaplan-Meier曲线分析了院内死亡的危险因素。结果:在多变量Cox回归模型中,在调整了年龄、性别、合并症和住院药物后,ARB的使用与较低的全因死亡率相关(校正HR, 0.53;95% ci, 0.38-0.73;P < 0.001)。经倾向评分匹配分析,使用ARB与全因死亡率相关的调整HR为0.62 (95% CI, 0.40-0.88;P = 0.02)。进一步的亚组分析发现,使用ARB与全因死亡率相关的调整hr为0.52 (95% CI, 0.30-0.89;P = 0.016), 0.37 (95% ci, 0.21-0.64;P < 0.001), 0.42 (95% ci, 0.28-0.64;P < 0.001)和0.55 (95% CI, 0.37-0.84;P = 0.005),分别为心力衰竭、糖尿病、高胆固醇血症和重症COVID-19患者。结论:ARB给药与COVID-19和cvd患者全因死亡风险降低显著相关。试验注册:ClinicalTrials.gov NCT05615792。https://www.Clinicaltrials gov / ct2 /显示/ NCT05615792。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Beneficial Effects of Angiotensin II Receptor Blockers on Mortality in Patients with COVID-19: A Retrospective Study from 2019 to 2020 in China.

Beneficial Effects of Angiotensin II Receptor Blockers on Mortality in Patients with COVID-19: A Retrospective Study from 2019 to 2020 in China.

Background: The COVID-19 pandemic has become a serious global public health problem. Although the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) has been recommended in patients with COVID-19 and cardiovascular diseases (CVDs), according to the results of some small-sample retrospective analyses, there remains a lack of sufficient evidence to validate their efficacy. This multicenter retrospective study investigated whether ACEI/ARB administration was beneficial in patients with COVID-19 and CVDs.

Methods: A total of 11,231 patients with confirmed COVID-19 and CVDs, from 138 hospitals in Hubei Province, were included in this multicenter retrospective study. We compared the clinical characteristics and outcomes between the ARB and non-ARB groups and analyzed the risk factors for in-hospital death using univariate and multivariate Cox regression analyses and Kaplan-Meier curves.

Results: In the multivariate Cox regression model, after adjusting for age, gender, comorbidities, and in-hospital medications, ARB use was associated with lower all-cause mortality (adjusted HR, 0.53; 95% CI, 0.38-0.73; P < 0.001). After propensity score-matched analysis, the adjusted HR for the use of ARB associated with all-cause mortality was 0.62 (95% CI, 0.40-0.88; P = 0.02). Further subgroup analyses found that the adjusted HRs for the use of ARB associated with all-cause mortality were 0.52 (95% CI, 0.30-0.89; P = 0.016), 0.37 (95% CI, 0.21-0.64; P < 0.001), 0.42 (95% CI, 0.28-0.64; P < 0.001), and 0.55 (95% CI, 0.37-0.84; P = 0.005) in patients with heart failure, diabetes, and hypercholesterolemia, and severe COVID-19, respectively.

Conclusions: ARB administration was significantly associated with a lower risk of all-cause mortality in patients with COVID-19 and CVDs.

Trial registration: ClinicalTrials.gov NCT05615792. https://www.

Clinicaltrials: gov/ct2/show/NCT05615792.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Cardiovascular Drugs and Therapy
Cardiovascular Drugs and Therapy 医学-心血管系统
CiteScore
8.30
自引率
0.00%
发文量
110
审稿时长
4.5 months
期刊介绍: Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信