Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol.


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin-converting enzyme 2 (ACE2), which facilitates SARS-CoV-2 host cell entry, may be impacted by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long-term outpatient ACEI or ARB upon hospitalization with COVID-19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.





Published Version (Please cite this version)


Publication Info

Cohen, Jordana B, Thomas C Hanff, Vicente Corrales-Medina, Preethi William, Nicolas Renna, Nelson R Rosado-Santander, Juan E Rodriguez-Mori, Jonas Spaak, et al. (2020). Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol. Journal of clinical hypertension (Greenwich, Conn.), 22(10). pp. 1780–1788. 10.1111/jch.14011 Retrieved from https://hdl.handle.net/10161/30459.

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N. Alejandro (Alex) Barbagelata

Adjunct Professor in the Department of Medicine

Medical degree at the University of Buenos Aires. Residency/Cardiology Fellowship at the Sanatorio Guemes/Favaloro Foundation. Cardiac cath fellow at the Sanatorio Guemes. International Scholar in Artificial Organs at the Cleveland Clinic. Duke Clinical Research Institute research fellow.

Faculty member in the Cardiology Division at the University of Texas Medical Branch with the rank of Assoc Professor of Medicine as CCU and Cardiac Cath Lab attending (invasive cardiologist) on all type of cardiovascular diseases Director or Associated Dir of the Advanced Heart Failure that included devices such as aquapheresis, 2.5 impella, Cardiac Power, and surgical such as being part of the approval team for destination therapy on Heart Mate II. UNOS primary physician in the Heart Transplant program 2011-2013. Current Adj Ast Professor Medicine/Cardiology at Duke University, member of the Board of Directors of DUCCS (a Duke Clinical Research organization). Director of the Advanced Heart Failure Postgraduate Program at the Universidad Catolica Argentina (UCA). Staff member Interventional Cardiology service at the Instituto del diagnostico y tratamiento, Buenos Aires, Argentina. 

Research Interest in Acute Myocardial Infarction and Heart Failure, percutaneous and surgical devices in heart failure. Early identification of STEMI such as criteria's for MI in LBBB (http://en.wikipedia.org/wiki/Sgarbossa's_criteria), new descriptors in Q wave/non Q wave, use of telemedicine for timeliness reperfusion. Co-editor of the book on “prehospital Management of Acute Myocardial Infarction” Member of the Int. Speaker Bureau AHA. Published more than 60 peer articles and more than 100 hundred abstract and speaker in a number of Scientific Meetings.


Daniel Len Edmonston

Assistant Professor of Medicine

My primary research focus lies at the intersection of kidney and cardiovascular disease including pulmonary hypertension, heart failure, and atherosclerotic disease in patients with chronic kidney disease. 

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