{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:10:32Z","timestamp":1791562232557,"version":"4.3.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":254,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to assess the impact of pre-admission beta-blocker (BB) therapy on the clinical characteristics, in-hospital treatment and outcomes of patients with cardiogenic shock (CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients enrolled in the multicentre prospective Altshock-2 registry since March 2020 with available data on pre-admission BB therapy were included. Clinical characteristics, in-hospital management, haemodynamic parameters and clinical outcomes were compared in patients with versus without BB therapy. The primary endpoint was in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 668 patients were included [median age 66 (56\u201374) years, male sex 76.5%]: 299 patients (44.8%) with and 369 patients (55.2%) without previous BB therapy. Patients receiving pre-admission BB therapy had more frequently heart failure-related CS (43.8% vs. 17.9%) and less frequently cardiac arrest at presentation (20.1% vs. 27.8%, P = 0.027). Levosimendan was used less frequently and dobutamine was used more frequently in patients with baseline BB therapy (P = 0.033 and P = 0.043, respectively). Differences in the early haemodynamic response to vasoactive drugs were observed between patients with and without previous BB therapy, with a significant impact of baseline BB on mean arterial pressure (MAP) response during norepinephrine infusion (P = 0.012) and with dobutamine having a reduced response in MAP and heart rate in patients receiving BBs before admission (P = 0.023 and P = 0.001, respectively). In-hospital mortality was not significantly different between the BB and no-BB groups (40% vs. 33.7%; adjusted odds ratio 1.32, 95% confidence interval 0.84\u20132.07, P = 0.224). Similarly, baseline BB therapy was not independently associated with 48 h mortality (12.7% vs. 14.6%; adjusted odds ratio 1.09, 95% confidence interval 0.64\u20131.87, P = 0.749). The lack of association between baseline BB therapy and mortality was also confirmed at inverse probability of treatment weighting-adjusted analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a real-world, contemporary cohort of patients with CS, previous BB therapy influenced the haemodynamic response to vasoactive drugs, but it was not associated with in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15322","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T08:44:54Z","timestamp":1749458694000},"page":"2565-2577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pre-Admission Beta-Blocker Therapy and Outcomes in Cardiogenic Shock: Insights from the Altshock-2 Registry"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-7871","authenticated-orcid":false,"given":"Matteo","family":"Pagnesi","sequence":"first","affiliation":[{"name":"Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Riccardi","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Sacco","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, \u2018De Gasperis\u2019 Cardio Center, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tavecchia","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, \u2018De Gasperis\u2019 Cardio Center, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Viola","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, \u2018De Gasperis\u2019 Cardio Center, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Frea","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Citt\u00e0 della Salute e della Scienza di Torino , Torino ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Briani","sequence":"additional","affiliation":[{"name":"Humanitas Research Hospital IRCCS Rozzano , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia Fausta","family":"Bertoldi","sequence":"additional","affiliation":[{"name":"Humanitas Research Hospital IRCCS Rozzano , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Bertaina","sequence":"additional","affiliation":[{"name":"Division of Cardiology, San Giovanni Bosco Hospital, ASL Citt\u00e0 di Torino , Torino ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Potena","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardio-Thoraco-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serafina","family":"Valente","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medical Biotechnologies, University of Siena , Siena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marini","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti , Ancona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano Maria","family":"De Ferrari","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Citt\u00e0 della Salute e della Scienza di Torino , Torino ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"D'Ettore","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale San Giacomo , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, AOU SS Antonio e Biagio e Cesare Arrigo , Alessandria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Camporotondo","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Fondazione Policlinico San Matteo Hospital IRCCS , Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Rota","sequence":"additional","affiliation":[{"name":"Units of Biostatistics and Biomathematics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia Italy Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione I , Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuccia","family":"Morici","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, ONLUS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"\u2018Kore\u2019 University, Policlinico Centro Cuore G.B. 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