Publication

Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors

Sama, I. E., Ravera, A., Santema, B. T., van Goor, H., Ter Maaten, J. M., Cleland, J. G. F., Rienstra, M., Friedrich, A. W., Samani, N. J., Ng, L. L., Dickstein, K., Lang, C. C., Filippatos, G., Anker, S. D., Ponikowski, P., Metra, M., van Veldhuisen, D. J. & Voors, A. A., 14-May-2020, In : European Heart Journal. 41, 19, p. 1810-1817 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Sama, I. E., Ravera, A., Santema, B. T., van Goor, H., Ter Maaten, J. M., Cleland, J. G. F., Rienstra, M., Friedrich, A. W., Samani, N. J., Ng, L. L., Dickstein, K., Lang, C. C., Filippatos, G., Anker, S. D., Ponikowski, P., Metra, M., van Veldhuisen, D. J., & Voors, A. A. (2020). Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. European Heart Journal, 41(19), 1810-1817. https://doi.org/10.1093/eurheartj/ehaa373

Author

Sama, Iziah E ; Ravera, Alice ; Santema, Bernadet T ; van Goor, Harry ; Ter Maaten, Jozine M ; Cleland, John G F ; Rienstra, Michiel ; Friedrich, Alex W ; Samani, Nilesh J ; Ng, Leong L ; Dickstein, Kenneth ; Lang, Chim C ; Filippatos, Gerasimos ; Anker, Stefan D ; Ponikowski, Piotr ; Metra, Marco ; van Veldhuisen, Dirk J ; Voors, Adriaan A. / Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. In: European Heart Journal. 2020 ; Vol. 41, No. 19. pp. 1810-1817.

Harvard

Sama, IE, Ravera, A, Santema, BT, van Goor, H, Ter Maaten, JM, Cleland, JGF, Rienstra, M, Friedrich, AW, Samani, NJ, Ng, LL, Dickstein, K, Lang, CC, Filippatos, G, Anker, SD, Ponikowski, P, Metra, M, van Veldhuisen, DJ & Voors, AA 2020, 'Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors', European Heart Journal, vol. 41, no. 19, pp. 1810-1817. https://doi.org/10.1093/eurheartj/ehaa373

Standard

Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. / Sama, Iziah E; Ravera, Alice; Santema, Bernadet T; van Goor, Harry; Ter Maaten, Jozine M; Cleland, John G F; Rienstra, Michiel; Friedrich, Alex W; Samani, Nilesh J; Ng, Leong L; Dickstein, Kenneth; Lang, Chim C; Filippatos, Gerasimos; Anker, Stefan D; Ponikowski, Piotr; Metra, Marco; van Veldhuisen, Dirk J; Voors, Adriaan A.

In: European Heart Journal, Vol. 41, No. 19, 14.05.2020, p. 1810-1817.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Sama IE, Ravera A, Santema BT, van Goor H, Ter Maaten JM, Cleland JGF et al. Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. European Heart Journal. 2020 May 14;41(19):1810-1817. https://doi.org/10.1093/eurheartj/ehaa373


BibTeX

@article{aa32f53c033d42ce8409ba5a8c9a0aa5,
title = "Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors",
abstract = "AIMS: The current pandemic coronavirus SARS-CoV-2 infects a wide age group but predominantly elderly individuals, especially men and those with cardiovascular disease. Recent reports suggest an association with use of renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors.METHODS AND RESULTS: We measured ACE2 concentrations in 1485 men and 537 women with heart failure (index cohort). Results were validated in 1123 men and 575 women (validation cohort).The median age was 69 years for men and 75 years for women. The strongest predictor of elevated concentrations of ACE2 in both cohorts was male sex (estimate = 0.26, P < 0.001; and 0.19, P < 0.001, respectively). In the index cohort, use of ACE inhibitors, angiotensin receptor blockers (ARBs), or mineralocorticoid receptor antagonists (MRAs) was not an independent predictor of plasma ACE2. In the validation cohort, ACE inhibitor (estimate = -0.17, P = 0.002) and ARB use (estimate = -0.15, P = 0.03) were independent predictors of lower plasma ACE2, while use of an MRA (estimate = 0.11, P = 0.04) was an independent predictor of higher plasma ACE2 concentrations.CONCLUSION: In two independent cohorts of patients with heart failure, plasma concentrations of ACE2 were higher in men than in women, but use of neither an ACE inhibitor nor an ARB was associated with higher plasma ACE2 concentrations. These data might explain the higher incidence and fatality rate of COVID-19 in men, but do not support previous reports suggesting that ACE inhibitors or ARBs increase the vulnerability for COVID-19 through increased plasma ACE2 concentrations.",
keywords = "Aged, Angiotensin Receptor Antagonists/therapeutic use, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Betacoronavirus, Coronavirus Infections, Europe, Female, Heart Failure/blood, Humans, Male, Middle Aged, Mineralocorticoid Receptor Antagonists/therapeutic use, Pandemics, Peptidyl-Dipeptidase A/blood, Pneumonia, Viral, Renin-Angiotensin System/drug effects, Sex Factors",
author = "Sama, {Iziah E} and Alice Ravera and Santema, {Bernadet T} and {van Goor}, Harry and {Ter Maaten}, {Jozine M} and Cleland, {John G F} and Michiel Rienstra and Friedrich, {Alex W} and Samani, {Nilesh J} and Ng, {Leong L} and Kenneth Dickstein and Lang, {Chim C} and Gerasimos Filippatos and Anker, {Stefan D} and Piotr Ponikowski and Marco Metra and {van Veldhuisen}, {Dirk J} and Voors, {Adriaan A}",
note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\textcopyright} The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.",
year = "2020",
month = may,
day = "14",
doi = "10.1093/eurheartj/ehaa373",
language = "English",
volume = "41",
pages = "1810--1817",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "19",

}

RIS

TY - JOUR

T1 - Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors

AU - Sama, Iziah E

AU - Ravera, Alice

AU - Santema, Bernadet T

AU - van Goor, Harry

AU - Ter Maaten, Jozine M

AU - Cleland, John G F

AU - Rienstra, Michiel

AU - Friedrich, Alex W

AU - Samani, Nilesh J

AU - Ng, Leong L

AU - Dickstein, Kenneth

AU - Lang, Chim C

AU - Filippatos, Gerasimos

AU - Anker, Stefan D

AU - Ponikowski, Piotr

AU - Metra, Marco

AU - van Veldhuisen, Dirk J

AU - Voors, Adriaan A

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

PY - 2020/5/14

Y1 - 2020/5/14

N2 - AIMS: The current pandemic coronavirus SARS-CoV-2 infects a wide age group but predominantly elderly individuals, especially men and those with cardiovascular disease. Recent reports suggest an association with use of renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors.METHODS AND RESULTS: We measured ACE2 concentrations in 1485 men and 537 women with heart failure (index cohort). Results were validated in 1123 men and 575 women (validation cohort).The median age was 69 years for men and 75 years for women. The strongest predictor of elevated concentrations of ACE2 in both cohorts was male sex (estimate = 0.26, P < 0.001; and 0.19, P < 0.001, respectively). In the index cohort, use of ACE inhibitors, angiotensin receptor blockers (ARBs), or mineralocorticoid receptor antagonists (MRAs) was not an independent predictor of plasma ACE2. In the validation cohort, ACE inhibitor (estimate = -0.17, P = 0.002) and ARB use (estimate = -0.15, P = 0.03) were independent predictors of lower plasma ACE2, while use of an MRA (estimate = 0.11, P = 0.04) was an independent predictor of higher plasma ACE2 concentrations.CONCLUSION: In two independent cohorts of patients with heart failure, plasma concentrations of ACE2 were higher in men than in women, but use of neither an ACE inhibitor nor an ARB was associated with higher plasma ACE2 concentrations. These data might explain the higher incidence and fatality rate of COVID-19 in men, but do not support previous reports suggesting that ACE inhibitors or ARBs increase the vulnerability for COVID-19 through increased plasma ACE2 concentrations.

AB - AIMS: The current pandemic coronavirus SARS-CoV-2 infects a wide age group but predominantly elderly individuals, especially men and those with cardiovascular disease. Recent reports suggest an association with use of renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors.METHODS AND RESULTS: We measured ACE2 concentrations in 1485 men and 537 women with heart failure (index cohort). Results were validated in 1123 men and 575 women (validation cohort).The median age was 69 years for men and 75 years for women. The strongest predictor of elevated concentrations of ACE2 in both cohorts was male sex (estimate = 0.26, P < 0.001; and 0.19, P < 0.001, respectively). In the index cohort, use of ACE inhibitors, angiotensin receptor blockers (ARBs), or mineralocorticoid receptor antagonists (MRAs) was not an independent predictor of plasma ACE2. In the validation cohort, ACE inhibitor (estimate = -0.17, P = 0.002) and ARB use (estimate = -0.15, P = 0.03) were independent predictors of lower plasma ACE2, while use of an MRA (estimate = 0.11, P = 0.04) was an independent predictor of higher plasma ACE2 concentrations.CONCLUSION: In two independent cohorts of patients with heart failure, plasma concentrations of ACE2 were higher in men than in women, but use of neither an ACE inhibitor nor an ARB was associated with higher plasma ACE2 concentrations. These data might explain the higher incidence and fatality rate of COVID-19 in men, but do not support previous reports suggesting that ACE inhibitors or ARBs increase the vulnerability for COVID-19 through increased plasma ACE2 concentrations.

KW - Aged

KW - Angiotensin Receptor Antagonists/therapeutic use

KW - Angiotensin-Converting Enzyme Inhibitors/therapeutic use

KW - Betacoronavirus

KW - Coronavirus Infections

KW - Europe

KW - Female

KW - Heart Failure/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Mineralocorticoid Receptor Antagonists/therapeutic use

KW - Pandemics

KW - Peptidyl-Dipeptidase A/blood

KW - Pneumonia, Viral

KW - Renin-Angiotensin System/drug effects

KW - Sex Factors

U2 - 10.1093/eurheartj/ehaa373

DO - 10.1093/eurheartj/ehaa373

M3 - Article

C2 - 32388565

VL - 41

SP - 1810

EP - 1817

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 19

ER -

ID: 128599345