Key result
Discontinuing beta blockers in cardiogenic shock linked to higher 1-month mortality.
Why the study?
Beta blocker use in patients recovering from cardiogenic shock remains controversial, especially regarding whether and when to reintroduce them.
Does beta blocker use (continuation or early introduction) improve 1-month and 1-year all-cause mortality in patients with cardiogenic shock?
Observational (n=772)
Yes
Does beta blocker use (continuation or early introduction) improve 1-month and 1-year all-cause mortality in patients with cardiogenic shock?
Discontinuation of beta blockers within 24 hours of cardiogenic shock is associated with increased 1-month mortality, suggesting they should be continued when possible.
Beta blocker discontinuation was associated with higher 1-month mortality in cardiogenic shock; leaves open whether continuation improves outcomes in randomized trials.
BACKGROUND: Beta blockers (BBs) are a cornerstone for patients with heart failure (HF) and ventricular dysfunction. However, their use in patients recovering from a cardiogenic shock (CS) remains a bone of contention, especially regarding whether and when to reintroduce this class of drugs. METHODS: FRENSHOCK is a prospective multicenter registry including 772 CS patients from 49 centers. Our aim was to compare outcomes (1-month and 1-year all-cause mortality) between CS patients taking and those not taking BBs in three scenarios: (1) at 24 h after CS; (2) patients who did or did not discontinue BBs within 24 h; and (3) patients who did or did not undergo the early introduction of BBs. RESULTS: = 0.03) and a trend to lower 1-year mortality. No reduction in outcomes was observed in patients who underwent an early introduction of BB therapy. CONCLUSIONS: BBs are drugs of first choice in patients with HF and should also be considered early in patients with CS. In contrast, the discontinuation of BB therapy resulted in increased 1-month all-cause mortality and a trend toward increased 1-year all-cause mortality.
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Cardelli et al. (2023) conducted an observational in Cardiogenic shock (n=772). Beta blockers vs. Not taking or discontinuing beta blockers was evaluated on 1-month and 1-year all-cause mortality (p=0.03). Discontinuation of beta blocker therapy in patients with cardiogenic shock resulted in increased 1-month all-cause mortality (P=0.03) and a trend toward increased 1-year mortality.
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