PhD Scientific Days 2026

Poster Session 2.Q - Cardiovascular Medicine and Research

Chronic Beta-blocker Therapy in Patients After Cardiac Arrest: Mortality and Catecholamine Requirement

Name of the presenter

Koós, Gábor

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Centre

Authors

Dr. Koós Gábor¹, Dr. Kiss Dénes Zsolt¹, Batki Barna Tamás², Dr. Pál-Jakab Ádám¹, Dr. Nagy Bettina¹, Dr. Kiss Boldizsár¹, Morvai Anna², Skorka Eszter², Prof. Dr. Merkely Béla¹, Prof. Dr. Zima Endre¹
1: Semmelweis University, Heart and Vascular Centre
2: Semmelweis University, Faculty of General Medicine

Text of the abstract

Introduction: Sudden cardiac death (SCD) is a leading cause of cardiovascular mortality worldwide, and outcomes are shaped by numerous clinical and etiological factors. Beta-receptor blocker (BB) therapy is widely used in cardiovascular diseases; however, in the post–cardiac arrest population, published data are conflicting regarding its impact on prognosis and the need for intensive care hemodynamic support.

Aims: To examine the association of chronic BB exposure with 30-, 90-, and 365-day mortality, the epinephrine dose administered during advanced life support (ALS), and the extent of intensive care hemodynamic support.

Method: At the Semmelweis University, Heart and Vascular Centre, we prospectively recorded data from 100 post–cardiac arrest patients treated in the intensive care unit. Analyses included descriptive statistics, Kaplan–Meier analysis, the Mann–Whitney test, and Pearson correlation. To enable comparability across different BB agents, we created an exposure index based on WHO-Defined Daily Dose (WHO-DDD) (BEI; dose taken/DDD). Catecholamine requirement was characterized using the Inotropic Score (IS).

Results: The median age was 62.4 years (IQR: 53.15–70.75). The most common comorbidity was hypertension and the initial rhythm of SCD was shockable in 70% of cases. Kaplan–Meier analysis showed no significant association between chronic BB use and 30/90/365-day mortality. The amount of epinephrine administered during ALS did not differ significantly between BB users and non-users. In contrast, BEI showed a positive correlation with IS at 24 and 72 hours (p = 0.041; p = 0.038).

Conclusion: Chronic beta-blocker therapy was not associated with differences in mortality and did not meaningfully affect the epinephrine dose used during ALS. Higher BEI was however associated with greater inotropic requirements, supporting a dose-dependent post-resuscitation hemodynamic vulnerability related to BB therapy. Larger studies are needed to confirm these findings.

Funding: Supported by the 2025-2.1.2-EKÖP-KDP-2025-00007 University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.