Evidence map›Paper›PMID 40488449›Full record

ArticleESC heart failure2025

Pre-admission beta-blocker therapy and outcomes in cardiogenic shock: Insights from the Altshock-2 Registry.

Matteo Pagnesi, Mauro Riccardi, Alice Sacco, Giovanni Tavecchia, Giovanna Viola, Simone Frea, Martina Briani, Letizia Fausta Bertoldi, Maurizio Bertaina, Luciano Potena and 12 more

Abstract readMulticenter Study
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Matteo PagnesiInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.ORCID https://orcid.org/0000-0002-9298-7871
Mauro RiccardiInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.
Alice SaccoCardiac Intensive Care Unit, 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Giovanni TavecchiaCardiac Intensive Care Unit, 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Giovanna ViolaCardiac Intensive Care Unit, 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Simone FreaCardiac Intensive Care Unit, Città della Salute e della Scienza di Torino, Torino, Italy.
Martina BrianiHumanitas Research Hospital IRCCS Rozzano, Milan, Italy.
Letizia Fausta BertoldiHumanitas Research Hospital IRCCS Rozzano, Milan, Italy.
Maurizio BertainaDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy.
Luciano PotenaCardiology Unit, Cardio-Thoraco-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
Serafina ValenteDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Marco MariniDepartment of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, Ancona, Italy.
Gaetano Maria De FerrariCardiac Intensive Care Unit, Città della Salute e della Scienza di Torino, Torino, Italy.
Nicoletta D'EttoreDivision of Cardiology, Ospedale San Giacomo, Genoa, Italy.
Astrid CardinaleDepartment of Cardiothoracic and Vascular Anesthesia and Intensive Care, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Rita CamporotondoCardiac Intensive Care Unit, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy.
Matteo RotaUnits of Biostatistics and Biomathematics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Guido TavazziDepartment of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia Italy Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione I, Pavia, Italy.
Nuccia MoriciIRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy.
Federico Pappalardo'Kore' University, Policlinico Centro Cuore G.B. Morgagni, Catania, Italy.
Marco MetraInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.
Altshock‐2 investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe aimed to assess the impact of pre-admission beta-blocker (BB) therapy on the clinical characteristics, in-hospital treatment and outcomes of patients with cardiogenic shock (CS).

methodsAll patients enrolled in the multicentre prospective Altshock-2 registry since March 2020 with available data on pre-admission BB therapy were included. Clinical characteristics, in-hospital management, haemodynamic parameters and clinical outcomes were compared in patients with versus without BB therapy. The primary endpoint was in-hospital mortality.

resultsA total of 668 patients were included [median age 66 (56-74) years, male sex 76.5%]: 299 patients (44.8%) with and 369 patients (55.2%) without previous BB therapy. Patients receiving pre-admission BB therapy had more frequently heart failure-related CS (43.8% vs. 17.9%) and less frequently cardiac arrest at presentation (20.1% vs. 27.8%, P = 0.027). Levosimendan was used less frequently and dobutamine was used more frequently in patients with baseline BB therapy (P = 0.033 and P = 0.043, respectively). Differences in the early haemodynamic response to vasoactive drugs were observed between patients with and without previous BB therapy, with a significant impact of baseline BB on mean arterial pressure (MAP) response during norepinephrine infusion (P = 0.012) and with dobutamine having a reduced response in MAP and heart rate in patients receiving BBs before admission (P = 0.023 and P = 0.001, respectively). In-hospital mortality was not significantly different between the BB and no-BB groups (40% vs. 33.7%; adjusted odds ratio 1.32, 95% confidence interval 0.84-2.07, P = 0.224). Similarly, baseline BB therapy was not independently associated with 48 h mortality (12.7% vs. 14.6%; adjusted odds ratio 1.09, 95% confidence interval 0.64-1.87, P = 0.749). The lack of association between baseline BB therapy and mortality was also confirmed at inverse probability of treatment weighting-adjusted analysis.

conclusionsIn 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.

Indexed as

Adrenergic beta-AntagonistsRegistriesShock, CardiogenicAgedFemaleFollow-Up StudiesHemodynamicsHospital MortalityHumansMaleMiddle AgedProspective StudiesSurvival RateTreatment OutcomeAdrenergic beta-Antagonistsbeta‐blockersCardiogenic shockinotropesmortalityvasopressors

Identifiers

PMID40488449
PMCPMC12287813

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.