Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study.

Q: What are the key findings of this study?

Premorbid beta-blocker exposure was associated with preserved cardiac function, demonstrated by lower levels of cardiac troponin I (87.9 vs 142.0 pg/ml, p=0.004) and higher left ventricular ejection fraction (58% vs 55%).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Sepsis (n=1005). Intervention: Premorbid beta-blockers vs. No premorbid beta-blocker exposure. Primary outcome: Cardiac troponin I (TnI) level (myocardial injury marker) (p=0.004).

Q: What does this research mean for the field?

Premorbid beta-blocker use in septic patients is associated with preserved cardiac function, including higher left ventricular ejection fraction, and significantly lower short-term mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Siyu Yang; Rongyao Feng; Xiangzhou Fang; Chaojie Wei

doi:10.62838/jccm-2026-0014

April 1, 2026Open Access

Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study.

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Key result

Premorbid beta-blocker exposure is linked to ~38% lower troponin I levels and preserved cardiac function.

P=0.004
n=1,005

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Why the study?

Beta-blockers have shown potential benefits in sepsis, but their clinical use remains limited due to concerns regarding hemodynamic impacts.

Does premorbid use of beta-blockers improve cardiac function and mortality outcomes in patients with sepsis?

Key Points

To evaluate whether premorbid beta-blocker therapy is associated with preserved cardiac function and improved survival among patients admitted to the intensive care unit with sepsis.
Conducted a single-center retrospective cohort study of adult sepsis patients admitted to an intensive care unit at a university-affiliated hospital between August 2022 and March 2024 (N=1005).
Compared patients receiving beta-blockers for at least 30 days prior to admission (n=228) with non-users (n=777), excluding those hospitalized under 48 hours or with severe underlying cardiac conditions.
Premorbid beta-blocker use was associated with lower cardiac troponin I (87.9 vs 142.0, p=0.004), B-type natriuretic peptide (267.9 vs 509.3, p=0.002), and lactic dehydrogenase (274.0 vs 319.0, p=0.022), along with higher left ventricular ejection fraction (58.0 vs 55.0, p=0.009).
Patients with premorbid beta-blockers had lower 28-day mortality (17.5% vs 27.4%; adjusted OR, 0.516; 95% CI, 0.346–0.770; p=0.001; HR, 0.61; 95% CI, 0.46–0.82; p=0.004) and in-hospital mortality (18.9% vs 28.8%; adjusted OR, 0.524; 95% CI, 0.535–0.776; p=0.001).

Study Design

Type

Cohort (n=1,005)

Multicenter

No

Structured PICO

Does premorbid use of beta-blockers improve cardiac function and mortality outcomes in patients with sepsis?

P

Population

1,005 adult ICU patients with sepsis, mean age 70, without pre-existing severe cardiac conditions, evaluated for the association of premorbid beta-blocker use with cardiac function and mortality.

E

Exposure

Premorbid beta-blockers initiated at least 30 days prior to ICU admission (>90% selective β-receptor blockers, mostly metoprolol).

C

Comparator

No premorbid beta-blocker exposure.

O

Outcome

Cardiac function assessed by myocardial injury biomarkers (including TnI, BNP, LDH), echocardiographic parameters, and electrocardiographic indices.surrogate

Main Result

Absolute Event Rate: 87.9% vs 142%

p-value: p=0.004

Premorbid beta-blocker use is associated with preserved cardiac function, reduced myocardial injury, and lower short-term mortality in patients admitted to the ICU with sepsis.

Limitations

Retrospective, single-center design with inherent potential for selection bias and unmeasured confounding
Lack of data on specific beta-blocker dosages, duration of therapy beyond 30 days, and adherence
Clinical data limited to ICU admission without emergency department or general ward information
Absence of a standardized dosage regimen for beta-blocker administration
Retrospective, single-center study with potential for selection bias and unmeasured confounding
Data on beta-blocker dosages, duration of therapy beyond 30 days, and adherence were not available
Clinical data were limited to ICU admission without capturing early sepsis data from the emergency department
Absence of a standardized dosage regimen

Implication

Should not yet change sepsis management; leaves open whether premorbid beta-blockers protect cardiac function, warranting prospective trials.

Abstract

Background: Beta-blockers have been reported to exert potential beneficial effects in sepsis in recent years. However, their clinical application in sepsis remains limited due to concerns regarding hemodynamic impacts. This study aims to explore whether premorbid use of beta-blockers is associated with improvements in cardiac function and favorable clinical outcomes among patients with sepsis. Methods: This single-center, retrospective cohort study was conducted in the Intensive Care Unit (ICU) of a university-affiliated hospital. All patients diagnosed with sepsis admitted between August 2022 and March 2024 were enrolled. Exclusion criteria included age < 18 years, hospitalization duration < 48 hours, a history of severe underlying cardiac conditions, and incomplete clinical records. Primary outcomes included myocardial injury markers, echocardiographic parameters, and electrocardiographic indices to assess cardiac function. Secondary outcome was mortality. Results: Among 1005 septic patients, 228 had received premorbid beta-blockers. No significant difference in baseline disease severity was observed between the two groups. Patients with premorbid beta-blocker exposure had lower levels of cardiac troponin I (TnI, 87.9 [IQR, 23.4-306.0] vs 142.0 [IQR, 37.8-481.2]), lactic dehydrogenase (LDH, 274.0 [IQR, 175.0-496.0] vs 319.0 [IQR, 229.0-456.8]), and B-type natriuretic peptide (BNP, 267.9 [IQR, 118.1-1065.1] vs 509.3 [IQR, 184.8-1203.0]). Echocardiographic assessments revealed that premorbid beta-blockers were associated with a higher left ventricular ejection fraction (LVEF, 58% [IQR 52-60] vs 55% [IQR 50-60]). Additionally, premorbid beta-blockers were linked to lower 14-day (13.6% [IQR 9.1-18.1] vs 21.5% [IQR 18.6-24.4]), 28-day (17.5% [IQR 12.6-22.5] vs 27.4% [IQR 24.3-30.6]), and in-hospital (18.9% [IQR 13.7-24.0] vs 28.8% [IQR 25.6-32.0]) mortality rates. Conclusions: Among septic patients, premorbid beta-blockers are associated with preserved cardiac function and improved clinical outcomes. These findings highlight the need for prospective or randomized controlled trials to further explore the potential cardioprotective role of beta-blockers in sepsis.

Discussion

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Cite This Study

Yang et al. (2026) conducted a cohort in Sepsis (n=1,005). Premorbid beta-blockers vs. No premorbid beta-blocker exposure was evaluated on Cardiac troponin I (TnI) level (myocardial injury marker) (p=0.004). Premorbid beta-blocker exposure was associated with preserved cardiac function, demonstrated by lower levels of cardiac troponin I (87.9 vs 142.0 pg/ml, p=0.004) and higher left ventricular ejection fraction (58% vs 55%).

synapsesocial.com/papers/6a0ea0f7be05d6e3efb5f5ee https://doi.org/10.62838/jccm-2026-0014

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Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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