The Relationship Between Beta-Blocker Use and Prognosis of Patients With Out-of-Hospital Cardiac Arrest.

BACKGROUND

Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. Patients with shockable rhythms often have better outcomes than those with nonshockable rhythms. A previous study reported a decline in shockable rhythms and poorer outcomes with the use of beta-blockers before OHCA. This study aimed to investigate the association between beta-blocker use and outcomes in OHCA patients using data from a multicenter prospective observational study in Japan.

PATIENTS AND METHODS

This study is a post hoc analysis based on data from the Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area 2017 study, which included 9,909 OHCA patients in Japan. Patients aged 18 years or older with cardiogenic OHCA were included in the analysis, which involved multiple imputation and overlap weighting with propensity scores. As a subgroup analysis, data were extracted for patients with a history of cardiovascular disease and who were also subjected to multiple imputations and overlapping weighting. The outcomes were survival and favorable neurological outcomes at 30 days.

RESULTS

Out of the 5,392 analyzed patients, 96 were taking beta-blockers before OHCA, and 5,296 were not. After adjusting for confounding factors using overlap weighting, beta-blocker use was not found to be associated with increased survival (odds ratio, OR, 1.07; 95% confidence interval, CI, 0.64-1.81) and favorable neurological outcomes (OR, 1.09; 95% CI, 0.61-1.95). The analysis of patients with a history of cardiovascular disease also showed no significant difference in survival based on beta-blocker use.

CONCLUSION

In this study, beta-blocker use was not associated with survival and favorable neurological outcomes in OHCA patients.