Prior RAAS Inhibitor Use Reduces hs-cTnT Levels in SARS-CoV-2 Infection

This study investigated whether daily RAAS inhibitor use by adults with hypertension provides cardioprotective benefits against COVID-19.

The following article is a part of conference coverage from the American College of Cardiology’s 70th Annual Scientific Session & Expo is being held virtually from May 15 to 17, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by clinicians and scientists in the field. Check back for more from the ACC 2021 .

Renin-angiotensin-aldosterone system (RAAS) inhibitor use prior to SARS-CoV-2 infection may lead to decreased high-sensitivity cardiac troponin T (hs-cTnT) values in patients with hypertension, according to research results presented at the American College of Cardiology (ACC) 2021 Annual Meeting, held virtually May 15-17, 2021.

To clarify the relationship between RAAS inhibitors and cardiac troponin levels in people with COVID-19, researchers conducted a single-institution, retrospective cohort study of adult patients diagnosed via PCR with SARS-CoV-2 infection. The primary study objective was to determine if evidence exists to support the current hypothesis that adults with hypertension receive cardioprotective benefits from daily RAAS inhibitor use prior to acquiring COVID-19.

The study cohort included 112 patients with hypertension and PCR-confirmed SARS-CoV-2 infection. Within this group, 57.1% were taking a RAAS inhibitor at the time of their diagnosis.

At 0- and 2-hours evaluation, patients on RAAS inhibitor therapy had median hs-cTnT values of 16.0 ng/L and 16.5 ng/L (interquartile range [IQR], 12.0-36.5 ng/L and 12.0-33.5 ng/L), respectively, compared with median hs-cTnT values of 34.5 ng/L and 32.0 ng/L (IQR, 17.8-77.5 ng/L and 16.0-67.0 ng/L), respectively, in patients not on RAAS inhibitor therapy.

The decreased hs-cTnT values in patients taking RAAS inhibitors persisted following investigator adjustment for age, sex, congestive heart failure history, coronary artery disease, and diabetes (regression coefficient −24.6 and −20.5 at 0 and 2 hours, respectively).

“RAAS inhibitor use prior to acquisition of COVID-19 is associated with decreased hs-cTnT values on [emergency department] presentation,” the researchers concluded. “RAAS inhibitors may attenuate myocardial injury in patients with COVID-19 and their role in this setting warrants further study.”

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Holmes A, Nelson J, Hirschl J, et al. RAAS inhibitors are cardioprotective in patients with COVID-19. Presented at: American College of Cardiology (ACC) 2021 Annual Meeting; May 15-17, 2021. Abstract.