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• W4365144777 abstract "Introduction Cardiogenic shock (CS) is a state of low cardiac output that manifests as tissue hypoperfusion and end-organ damage. Acute decompensated heart failure (ADHF) is one of the leading causes of CS and mortality remains high despite medical advances. Current guidelines do not provide recommendations regarding beta blocker (BB) use in CS. This study sought to analyze the effects of BB continuation on in-hospital mortality among patients admitted with ADHF resulting in CS. Methods A single center, retrospective, non-blinded study was conducted in patients hospitalized with ADHF over a three-year period. Patients were further stratified for the presence of CS using the Society for Cardiovascular Angiography and Interventions Classification of Cardiogenic Shock (SCAI) and Get With the Guidelines Heart Failure (GWTG-HF) Risk Score. Inclusion criteria were patients ≥ 18 years of age admitted with ADHF and treated with inotropes from 1/1/2017-1/1/2020 at Atrium Health Wake Forest Baptist Medical Center. BB continuation was assessed at admission and was defined as administration for at least 50% of the hospital stay. Patients were differentiated into tertiles and quartiles for SCAI and GWTG-HF Risk Score, respectively, and the lowest category served as the reference level for testing. A time to event analysis framework was implemented using Cox proportional hazards models to analyze the effect of BB continuation on in-hospital mortality. Results A total of 449 patients were admitted with ADHF requiring inotropes who met study criteria. Twelve patients were excluded, as there was insufficient data to calculate GWTG-HF Risk Score. In the highest category, SCAI and GTWG-HF Risk Scores were associated with increased in-hospital mortality (Table 1). When adjusted for SCAI and GWTG-HF Risk Score, there is a significant mortality benefit of BB continuation with a 65% reduction in mortality [HR 0.35 95% CI 0.19-0.64, p=0.0008]. Conclusion In select patients with ADHF resulting in CS, there is a mortality benefit associated with continuation of BB on admission that is significant despite adjustment for severity of CS. Generalizability and statistical power is limited in this single-center study with a small sample size." @default.
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• W4365144777 date "2023-04-01" @default.
• W4365144777 modified "2023-10-16" @default.
• W4365144777 title "Blocked At The Door: Benefits Of Beta Blockers In Cardiogenic Shock" @default.
• W4365144777 doi "https://doi.org/10.1016/j.cardfail.2022.10.081" @default.
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