Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease
Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID-19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events.Methods and Results This study was conducted using data fro...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2023 |
| País: | España |
| Recursos: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositório: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:iibsantpau.fundanetsuite.com:p16580 |
| Acesso em linha: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16580 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165220703&doi=10.1161%2fJAHA.122.028939&partnerID=40&md5=46e32d9ad7a10ee136c464cb7c75b8f5 |
| Access Level: | Acceso aberto |
| Palavra-chave: | acute heart failure azithromycin cardiovascular diseases COVID-19 |
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Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular DiseaseBergami, MManfrini, ONava, SCaramori, GYoon, JBadimon, LCenko, EDavid, ADemiri, IDorobantu, MFabin, NGheorghe-Fronea, OJankovic, RKedev, SLadjevic, NLasica, RLoncar, GMancuso, GMendieta, GMilicic, DMjehovic, PPasalic, MPetrovic, MPoposka, LScarpone, MStefanovic, Mvan der Schaar, MVasiljevic, ZVavlukis, MPittao, MLVVukomanovic, VZdravkovic, MBugiardini, Racute heart failureazithromycincardiovascular diseasesCOVID-19Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID-19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events.Methods and Results This study was conducted using data from the ISACS-COVID-19 (International Survey of Acute Coronavirus Syndromes-COVID-19) registry. Patients with a confirmed diagnosis of SARS-CoV-2 infection were eligible for inclusion. The study included 793 patients exposed to azithromycin within 24 hours from hospital admission and 2141 patients who received only standard care. The primary exposure was cardiovascular disease (CVD). Main outcome measures were 30-day mortality and acute heart failure (AHF). Among 2934 patients, 1066 (36.4%) had preexisting CVD. A total of 617 (21.0%) died, and 253 (8.6%) had AHF. Azithromycin therapy was consistently associated with an increased risk of AHF in patients with preexisting CVD (risk ratio [RR], 1.48 [95% CI, 1.06-2.06]). Receiving azithromycin versus standard care was not significantly associated with death (RR, 0.94 [95% CI, 0.69-1.28]). By contrast, we found significantly reduced odds of death (RR, 0.57 [95% CI, 0.42-0.79]) and no significant increase in AHF (RR, 1.23 [95% CI, 0.75-2.04]) in patients without prior CVD. The relative risks of death from the 2 subgroups were significantly different from each other (P-interaction=0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34-3.90]).Conclusions These findings suggest that azithromycin use in patients with COVID-19 and prior history of CVD is significantly associated with an increased risk of AHF and all-cause 30-day mortality.WILEY2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16580https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165220703&doi=10.1161%2fJAHA.122.028939&partnerID=40&md5=46e32d9ad7a10ee136c464cb7c75b8f5Journal of the American Heart AssociationISSN: 20479980reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p165802026-06-14T12:41:47Z |
| dc.title.none.fl_str_mv |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| title |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| spellingShingle |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease Bergami, M acute heart failure azithromycin cardiovascular diseases COVID-19 |
| title_short |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| title_full |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| title_fullStr |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| title_full_unstemmed |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| title_sort |
Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease |
| dc.creator.none.fl_str_mv |
Bergami, M Manfrini, O Nava, S Caramori, G Yoon, J Badimon, L Cenko, E David, A Demiri, I Dorobantu, M Fabin, N Gheorghe-Fronea, O Jankovic, R Kedev, S Ladjevic, N Lasica, R Loncar, G Mancuso, G Mendieta, G Milicic, D Mjehovic, P Pasalic, M Petrovic, M Poposka, L Scarpone, M Stefanovic, M van der Schaar, M Vasiljevic, Z Vavlukis, M Pittao, MLV Vukomanovic, V Zdravkovic, M Bugiardini, R |
| author |
Bergami, M |
| author_facet |
Bergami, M Manfrini, O Nava, S Caramori, G Yoon, J Badimon, L Cenko, E David, A Demiri, I Dorobantu, M Fabin, N Gheorghe-Fronea, O Jankovic, R Kedev, S Ladjevic, N Lasica, R Loncar, G Mancuso, G Mendieta, G Milicic, D Mjehovic, P Pasalic, M Petrovic, M Poposka, L Scarpone, M Stefanovic, M van der Schaar, M Vasiljevic, Z Vavlukis, M Pittao, MLV Vukomanovic, V Zdravkovic, M Bugiardini, R |
| author_role |
author |
| author2 |
Manfrini, O Nava, S Caramori, G Yoon, J Badimon, L Cenko, E David, A Demiri, I Dorobantu, M Fabin, N Gheorghe-Fronea, O Jankovic, R Kedev, S Ladjevic, N Lasica, R Loncar, G Mancuso, G Mendieta, G Milicic, D Mjehovic, P Pasalic, M Petrovic, M Poposka, L Scarpone, M Stefanovic, M van der Schaar, M Vasiljevic, Z Vavlukis, M Pittao, MLV Vukomanovic, V Zdravkovic, M Bugiardini, R |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
acute heart failure azithromycin cardiovascular diseases COVID-19 |
| topic |
acute heart failure azithromycin cardiovascular diseases COVID-19 |
| description |
Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID-19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events.Methods and Results This study was conducted using data from the ISACS-COVID-19 (International Survey of Acute Coronavirus Syndromes-COVID-19) registry. Patients with a confirmed diagnosis of SARS-CoV-2 infection were eligible for inclusion. The study included 793 patients exposed to azithromycin within 24 hours from hospital admission and 2141 patients who received only standard care. The primary exposure was cardiovascular disease (CVD). Main outcome measures were 30-day mortality and acute heart failure (AHF). Among 2934 patients, 1066 (36.4%) had preexisting CVD. A total of 617 (21.0%) died, and 253 (8.6%) had AHF. Azithromycin therapy was consistently associated with an increased risk of AHF in patients with preexisting CVD (risk ratio [RR], 1.48 [95% CI, 1.06-2.06]). Receiving azithromycin versus standard care was not significantly associated with death (RR, 0.94 [95% CI, 0.69-1.28]). By contrast, we found significantly reduced odds of death (RR, 0.57 [95% CI, 0.42-0.79]) and no significant increase in AHF (RR, 1.23 [95% CI, 0.75-2.04]) in patients without prior CVD. The relative risks of death from the 2 subgroups were significantly different from each other (P-interaction=0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34-3.90]).Conclusions These findings suggest that azithromycin use in patients with COVID-19 and prior history of CVD is significantly associated with an increased risk of AHF and all-cause 30-day mortality. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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Inglés |
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Journal of the American Heart Association ISSN: 20479980 reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
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