Impact of in-hospital oral beta-blockers initiation on long-term outcomes in ST-elevation myocardial infarction patients with cardiogenic shock

作者：Xiaojin Gao, Mengyuan Liu, Jing Xu, Ling Li, Min Chen, Xinyue Lang, Shaobin Jia, Bin Ning, Haiyan Xu, Lei Song, Yuan Wu, Jun Zhang, Fenghuan Hu, Shubin Qiao, Yongjian Wu, Yanyan Zhao, Yang Wang, Wei Li, Chen Jin, Jingang Yang, Yuejin Yang · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1666977 · 被引用次数：2 · 研究领域：Acute Myocardial Infarction Research、Mechanical Circulatory Support Devices、Sepsis Diagnosis and Treatment

Background Early revascularization enables ST-elevation myocardial infarction (STEMI) patients with cardiogenic shock (CS) to initiate oral beta-blockers once hemodynamic stability is achieved, but the impact of such initiation on prognosis remains unknown. We aimed to describe the clinical use of oral beta-blockers and assess its impact on long-term outcomes in STEMI patients with CS in a real-world setting. Materials and methods The China Acute Myocardial Infarction registry (CAMI) is a prospective observational study that enrolls patients with acute myocardial infarction from three-level hospitals across 31 administrative regions in mainland China. Among 19,112 STEMI patients in the CAMI registry, a total of 744 STEMI patients who presented with CS at admission were analyzed. Multivariate regression models were used to evaluate the impact of in-hospital oral beta-blockers on 2-year outcomes. Inverse probability treatment weighting (IPTW) score was further used to address biases between the groups with and without oral beta-blockers. The primary endpoint was all-cause death. Results 42.7% ( n = 318) of the patients initiated in-hospital oral beta-blockers; these patients were in better states and more likely to receive primary percutaneous coronary intervention and secondary prevention at discharge. The crude 2-year all-cause mortality was 41.7%, with a lower rate in patients who received oral beta-blockers (24.2% vs. 54.8%, P < 0.001). However, after multivariate ad...