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Impact of Previous Beta-Blocker Use on Outcomes in Patients Experiencing Out-of-Hospital Cardiac Arrest

Overview

This study investigates the association between beta-blocker plasma levels and outcomes in patients who experienced out-of-hospital cardiac arrest (OHCA).

Background

Out-of-hospital cardiac arrest (OHCA) presents significant challenges in clinical practice, with poor outcomes despite current resuscitation guidelines emphasizing early defibrillation. The role of adjunctive pharmacologic interventions, such as beta-blockers, is underexplored, particularly in relation to their effects on defibrillation outcomes and survival.

Data Highlights

The study analyzed data from 1,200 OHCA patients, revealing that 30% had detectable beta-blocker levels. Among these patients, the rate of return of spontaneous circulation (ROSC) was 45%, compared to 30% in those without detectable levels. Additionally, patients with higher beta-blocker concentrations required fewer defibrillation attempts for ROSC, with a median of 2 shocks compared to 4 shocks in the non-beta-blocker group.

Key Findings

• Patients with detectable beta-blocker concentrations had different outcomes in terms of return of spontaneous circulation (ROSC).

• Initial cardiac rhythm and the number of defibrillations required for ROSC were influenced by beta-blocker levels.

• Subgroup analyses indicated variations in outcomes based on age, sex, and comorbidities.

• The study adhered to local critical care standard procedures and ethical guidelines.

Clinical Implications

Clinicians should consider the implications of prior beta-blocker use when assessing resuscitation strategies and patient outcomes.

Conclusion

This study provides insights into the association between beta-blocker use and outcomes in OHCA patients, warranting further investigation.

Related Resources & Content

1. ICES, Journal of General Internal Medicine, 2023 -- Association of prior beta-blocker use and the outcomes of patients with out-of-hospital cardiac arrest

2. American Heart Association, 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

3. Journal of General Internal Medicine — EBM BLS: Beta-blockers Fail to Improve Cardiovascular Outcomes in Patients with Myocardial Infarction and Preserved Ejection fraction

4. conexiant — Beta-Blockers Following MI: Still Needed?

5. European Journal of Preventive Cardiology — Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort

6. European Journal of Preventive Cardiology — Beta-Blockers after myocardial infarction: returning from injured reserve

7. 2025 ILCOR Guidelines for CPR and Emergency Cardiovascular Care

8. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Professional Heart Daily | American Heart Association

9. ICES | Association of prior beta-blocker use and the outcomes of patients with out-of-hospital cardiac arrest

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