Cardiac Patients Hospitalized for COVID-19 May Continue Taking Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Antagonists (ARBs) Safely, According to BRACE CORONA Trial Presented at a Congressional Hotline Consultation ESC 2020.
ACE and ARA inhibitors are commonly taken through cardiac patients to lower blood pressure and treat center failure. There is conflicting evidence of the possible clinical influence of ACE and ARA inhibitors in patients with COVID-19. Some preclinical investigations have raised protection considerations. in patients with COVID-19, preliminary knowledge hypothesizes that renin-angiotensin-aldosterone (SRAA) formula inhibitors can gain advantages for patients with COVID-19 by cutting acute lung damage and preventing angiotensin-II-mediated lung inflammation.
Given the common use of these agents worldwide, evidence from randomized clinical trials is urgent to consult the control of COVID-19 patients.
The membrane-associated angiotensin conversion enzyme 2 (ACE2) is the functional receptor of SARS-CoV-2, the virus guilty of coronavirus 2019 disease (COVID-19). ARA inhibitors.
The BRACE CORONA trial, a phase four randomized and academic-led, examines the test of two strategies: discontinuing the transilability of the ACE/ARA inhibitor for 30 days compared to the continuation of ACE/ARA inhibitors in patients who were taking these drugs chronically and were hospitalized with a diagnosis of COVID-19. The number one endpoint is the number of days alive and out of the hospital at 30 days.
Patients who used more than 3 antihypertensive or sacubitril/valsartan, or who were hemodynamically volatile in the presentation, were excluded from the study.
The trial recruited 659 patients from 29 sites in Brazil. All participants were a chronic ACE or ARA inhibitor and were hospitalized by COVID-19. Patients were randomly assigned to prevent the ACE/ARA inhibitor for 30 days or continue taking ACE/ARA inhibitor.
The average days alive and out of the hospital was 21. 9 days for patients who discontinued IEC/ARA and 22. 9 days for patients who continued those medications. (95% confidence period [IC] 0. 90 to 1. 01, p -0. 09). The average difference between the equipment -1. 1 days (95% CI -2. 33 to 0. 17).
The proportion of living and non-hospitalized patients at the end of 30 days in the ACE/ARA inhibitory organization with suspected completion was 91. 8% compared to 95% in the ongoing organization. A mortality rate similar to 30 days was observed for patients who continued and suspicious ER/ARA (2. 8% vs. 2. 7%, respectively, with a threat rate of 0. 97).
These are the first randomized knowledge that compares the role of prosecution against discontinuation of ACE and ARA inhibitors in patients with COVID-19. In patients hospitalized for COVID-19, the suspension of ACE and ARA inhibitors for 30 days did not mean the number of days alive and outside the hospital. “
He concluded: “Because this knowledge implies that there are no clinical advantages in routine discontinuation of these drugs in patients hospitalized with mild to moderate COVID-19, they are sometimes processed by those with an indication. “
European Society of Cardiology
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