JACC:高危COVID-19患者能否接受雷米普利治疗?

2020-05-27 MedSci原创 MedSci原创

在高风险的老年心血管疾病患者人群中,雷米普利对COVID-19的发生率或严重性没有影响。该分析支持在COVID-19疫情期间继续RAAS抑制剂治疗。

冠状病毒疾病2019(COVID-19)由SARS-CoV2引起,该病毒通过血管紧张素转化酶2(ACE-2)与肾素-血管紧张素-醛固酮系统(RAAS)相互作用。已有学者提出这种相互作用是接受RAAS抑制剂治疗的患者潜在危险因素。近日,心血管领域权威杂志JACC上发表了一篇研究文章,该研究旨在分析RAAS抑制剂是否会改变COVID-19的感染风险。

RASTAVI(NCT03201185)是一项正在进行的随机临床试验,在西班牙的14个中心成功完成经导管主动脉瓣置换的患者随机分配至雷米普利组或对照组。研究人员进行了一项非预先确定的中期分析,以评估其对这一易感人群中COVID-19风险的影响。

截至2020年4月1日,该研究纳入了102例患者(50例患者服用雷米普利,52例患者服用对照药)。受试者平均年龄为82.3±6.1岁,男性为56.9%。雷米普利治疗的中位时间为6个月[IQR:2.9-11.4]。已确诊11例(10.8%)COVID-19患者(对照组6例,雷米普利组5例,HR=1.150 [95%CI:0.351-3.768])。根据胸外科医师协会评分更多合并症的患者(p=0.065)、老年患者(p=0.019)、房颤患者(p=0.066)、低血细胞比容患者(p=0.084)感染COVID-19的风险增加。4.9%的患者需要入院和吸氧(雷米普利组2例,对照组3例),其中4例死亡(每组2例)。较大的体重指数是增加死亡率的唯一因素(p=0.039)。

由此可见,在高风险的老年心血管疾病患者人群中,雷米普利对COVID-19的发生率或严重性没有影响。该分析支持在COVID-19疫情期间继续RAAS抑制剂治疗。

原始出处:

Ignacio J. Amat-Santos, et al.Ramipril in High Risk Patients with COVID-19.JACC.2020.https://www.onlinejacc.org/content/early/2020/05/22/j.jacc.2020.05.040

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    2021-02-06 hbwxf
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    2020-05-27 lovetcm

    已经多个研究证实了无影响了!🎈🎈

    0

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