ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Association of prior beta-blocker treatment and outcome in patients with out-of-hospital cardiac arrest.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOut-of-hospital cardiac arrest (OHCA) is associated with poor outcomes and presents a considerable treatment challenge. Here, we investigated the association of prior beta-blocker treatment with outcomes in patients with OHCA.
methodsWe enrolled consecutive OHCA patients with return of spontaneous circulation (ROSC). Beta-blocker plasma concentrations were measured upon admission and analyzed in relation to the number of defibrillations required to achieve ROSC, initial cardiac rhythm and in-hospital mortality.
resultsAmong 207 enrolled patients (median age 68 years, 71% male, 45% shockable rhythm), 65 (31.4%) had detectable beta-blocker plasma concentrations. Detectable beta-blocker concentrations were not associated with the likelihood of an initial shockable rhythm (adjusted odds ratio [OR] 0.99 [95% confidence interval [CI], 0.52-1.91]; P = 0.99), number of defibrillations (adjusted incidence rate ratio 0.93 [95% CI 0.63-1.37], P = 0.72) or doses of epinephrine (adjusted mean 7.4 vs. 6.7 mg, P = 0.29) and amiodarone (adjusted mean 99.3 vs. 93.9 mg, P = 0.83) administered to achieve ROSC. When analyzed as a continuous variable, beta-blocker concentration on admission was not associated with in-hospital death (adjusted OR 0.85 [95% CI 0.67-1.08]; P = 0.18). However, patients with plasma concentrations above the median had lower odds of death compared to those with undetectable levels or those below the median (adjusted OR 0.36 [95% CI 0.13-0.96]; P = 0.042).
conclusionIn OHCA patients with ROSC, detectable beta-blocker plasma concentrations on admission were not associated with defibrillation requirements or initial cardiac rhythm. While any detectable beta-blocker level was not associated with overall mortality, levels above the median were associated with lower odds of death in this cohort. These results are hypothesis-generating and warrant confirmation in larger independent cohorts.
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