Acute cardiac care & resuscitation
Pre-Admission Beta-Blocker Therapy and Outcomes in Cardiogenic Shock: Insights from the Altshock-2 Registry
Main finding · In-hospital mortalityResult — go to the resultAdjusted odds ratio 1.32 95% CI 0.84–2.07Authors' conclusion
In a real-world, contemporary cohort of patients with CS, previous BB therapy influenced the haemodynamic response to vasoactive drugs, but it was not associated with in-hospital mortality.
Study context
- Population
- Patients with cardiogenic shock (CS) enrolled since March 2020 with available data on pre-admission beta-blocker (BB) therapypatients included
- Participants
- 668 patients
- Exposure
- Patients with versus without BB therapy
- BBn = 299
- no-BBn = 369reference
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
Adjusted odds ratio
1.32
95% CI 0.84–2.07
P = 0.224
By group
BBvs no-BB
adjusted odds ratio 1.32 (95% CI 0.84–2.07); P = 0.224
Observational data: associations, not effects.
Further findings
| Outcome | BB | no-BB | Adjusted odds ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| 48 h mortality | 12.7% | 14.6% | 1.09 (0.64–1.87) | P = 0.749 | |
| 0.512Adjusted odds ratio (log scale) |
Heart failure-related CS
Cardiac arrest at presentation
- Cardiac arrest at presentation: P = 0.027
Baseline characteristics
- Median age, years
- 66 (56-74)
- Male sex
- 76.5%
Vasoactive drug use
- Levosimendan used less frequently with baseline BB therapy
- P = 0.033
- Dobutamine used more frequently with baseline BB therapy
- P = 0.043
Early haemodynamic response to vasoactive drugs
- Significant impact of baseline BB on mean arterial pressure (MAP) response during norepinephrine infusion
- P = 0.012
- Reduced MAP response to dobutamine with BBs before admission
- P = 0.023
- Reduced heart rate response to dobutamine with BBs before admission
- P = 0.001
Original publication
Pre-Admission Beta-Blocker Therapy and Outcomes in Cardiogenic Shock: Insights from the Altshock-2 Registry. ESC Heart Fail. Published 9 June 2025. doi:10.
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