Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms
Abstract The prognosis of out of cardiac arrest is poor and most cardiac arrest patients suffered from the non-shockable rhythm especially in patients without pre-existing cardiovascular diseases and medication prescription. Beta-blocker (ß-blocker) therapy has been shown to improve outcomes in card...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-96070-8 |
| _version_ | 1818843949333217280 |
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| author | Hui-Chun Huang Ping-Hsun Yu Min-Shan Tsai Kuo-Liong Chien Wen-Jone Chen Chien-Hua Huang |
| author_facet | Hui-Chun Huang Ping-Hsun Yu Min-Shan Tsai Kuo-Liong Chien Wen-Jone Chen Chien-Hua Huang |
| author_sort | Hui-Chun Huang |
| collection | DOAJ |
| description | Abstract The prognosis of out of cardiac arrest is poor and most cardiac arrest patients suffered from the non-shockable rhythm especially in patients without pre-existing cardiovascular diseases and medication prescription. Beta-blocker (ß-blocker) therapy has been shown to improve outcomes in cardiovascular diseases such as heart failure, ischemia related cardiac, and brain injuries. Therefore, we investigated whether prior ß-blockers use was associated with reduced mortality in patients with cardiac arrest and non-shockable rhythm. We conducted a population-based retrospective cohort study using multivariate propensity score–based regression to control for differences among patients with cardiac arrest. A total of 104,568 adult patients suffering a non-traumatic and non-shockable rhythm cardiac arrest between 2005 and 2011 were identified. ß-blocker prescription at least 30 days prior to the cardiac arrest event was defines as the ß-blockers group. We chose 12.5 mg carvedilol as the cut-off value and defined greater or equal to carvedilol 12.5 mg per day and its equivalent dose as high-dose group. After multivariate propensity score–based logistic regression analysis, patients with prior ß-blockers use were associated with better 1-year survival [adjusted odds ratio (OR), 1.15, 95% confidence interval (CI) 1.01–1.30; P = 0.031]. Compared to non-ß-blocker use group and prior low-dose ß-blockers use group, prior high-dose ß-blockers use group was associated with higher mechanical ventilator wean success rate (adjusted OR 1.19, 95% CI 1.01–1.41, P = 0.042). In conclusion, prior high dose ß-blockers use was associated with a better 1-year survival and higher weaning rate in patients with non-shockable cardiac arrest. |
| first_indexed | 2024-12-19T05:06:00Z |
| format | Article |
| id | doaj.art-868407e758524841a567d44c9941f130 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T05:06:00Z |
| publishDate | 2021-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-868407e758524841a567d44c9941f1302022-12-21T20:34:57ZengNature PortfolioScientific Reports2045-23222021-08-0111111010.1038/s41598-021-96070-8Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythmsHui-Chun Huang0Ping-Hsun Yu1Min-Shan Tsai2Kuo-Liong Chien3Wen-Jone Chen4Chien-Hua Huang5Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of MedicineDepartment of Emergency Medicine, Taipei Hospital, Ministry of Health and WelfareDepartment of Emergency Medicine, College of Medicine, National Taiwan UniversityGraduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan UniversityDepartment of Emergency Medicine, College of Medicine, National Taiwan UniversityDepartment of Emergency Medicine, College of Medicine, National Taiwan UniversityAbstract The prognosis of out of cardiac arrest is poor and most cardiac arrest patients suffered from the non-shockable rhythm especially in patients without pre-existing cardiovascular diseases and medication prescription. Beta-blocker (ß-blocker) therapy has been shown to improve outcomes in cardiovascular diseases such as heart failure, ischemia related cardiac, and brain injuries. Therefore, we investigated whether prior ß-blockers use was associated with reduced mortality in patients with cardiac arrest and non-shockable rhythm. We conducted a population-based retrospective cohort study using multivariate propensity score–based regression to control for differences among patients with cardiac arrest. A total of 104,568 adult patients suffering a non-traumatic and non-shockable rhythm cardiac arrest between 2005 and 2011 were identified. ß-blocker prescription at least 30 days prior to the cardiac arrest event was defines as the ß-blockers group. We chose 12.5 mg carvedilol as the cut-off value and defined greater or equal to carvedilol 12.5 mg per day and its equivalent dose as high-dose group. After multivariate propensity score–based logistic regression analysis, patients with prior ß-blockers use were associated with better 1-year survival [adjusted odds ratio (OR), 1.15, 95% confidence interval (CI) 1.01–1.30; P = 0.031]. Compared to non-ß-blocker use group and prior low-dose ß-blockers use group, prior high-dose ß-blockers use group was associated with higher mechanical ventilator wean success rate (adjusted OR 1.19, 95% CI 1.01–1.41, P = 0.042). In conclusion, prior high dose ß-blockers use was associated with a better 1-year survival and higher weaning rate in patients with non-shockable cardiac arrest.https://doi.org/10.1038/s41598-021-96070-8 |
| spellingShingle | Hui-Chun Huang Ping-Hsun Yu Min-Shan Tsai Kuo-Liong Chien Wen-Jone Chen Chien-Hua Huang Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms Scientific Reports |
| title | Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms |
| title_full | Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms |
| title_fullStr | Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms |
| title_full_unstemmed | Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms |
| title_short | Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms |
| title_sort | prior beta blocker treatment improves outcomes in out of hospital cardiac arrest patients with non shockable rhythms |
| url | https://doi.org/10.1038/s41598-021-96070-8 |
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