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Here, we investigated the association of prior beta-blocker treatment with outcomes in patients with OHCA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled consecutive OHCA patients with return of spontaneous circulation (ROSC). Beta-blocker plasma concentrations were measured upon admission and analyzed in relation to the number of defibrillations required to achieve ROSC, initial cardiac rhythm and in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 207 enrolled patients (median age 68\u00a0years, 71% male, 45% shockable rhythm), 65 (31.4%) had detectable beta-blocker plasma concentrations. Detectable beta-blocker concentrations were not associated with the likelihood of an initial shockable rhythm (adjusted odds ratio [OR] 0.99 [95% confidence interval [CI], 0.52\u20131.91];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.99), number of defibrillations (adjusted incidence rate ratio 0.93 [95% CI 0.63\u20131.37],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.72) or doses of epinephrine (adjusted mean 7.4 vs. 6.7\u00a0mg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.29) and amiodarone (adjusted mean 99.3 vs. 93.9\u00a0mg,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.83) administered to achieve ROSC. When analyzed as a continuous variable, beta-blocker concentration on admission was not associated with in-hospital death (adjusted OR 0.85 [95% CI 0.67\u20131.08];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.18). However, patients with plasma concentrations above the median had lower odds of death compared to those with undetectable levels or those below the median (adjusted OR 0.36 [95% CI 0.13\u20130.96];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.042).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In OHCA patients with ROSC, detectable beta-blocker plasma concentrations on admission were not associated with defibrillation requirements or initial cardiac rhythm. While any detectable beta-blocker level was not associated with overall mortality, levels above the median were associated with lower odds of death in this cohort. These results are hypothesis-generating and warrant confirmation in larger independent cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02968-6","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T06:58:19Z","timestamp":1782111499000},"page":"2038-2047","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of prior beta-blocker treatment and outcome in patients with out-of-hospital cardiac arrest"],"prefix":"10.1007","volume":"115","author":[{"given":"Fardin","family":"Hamidi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Muhler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Skopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Rusnak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudius","family":"Speer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Michels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Zelniker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Preusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"2968_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.resuscitation.2018.11.018","volume":"134","author":"J Soar","year":"2019","unstructured":"Soar J, Perkins GD, Maconochie I, B\u00f6ttiger BW, Deakin CD, Sandroni C (2019) European resuscitation council guidelines for resuscitation: 2018 update - antiarrhythmic drugs for cardiac arrest. 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FM has no conflicts of interest. GS has no conflicts of interest. JR has no conflicts of interest. CS has no conflicts of interest. GM has no conflicts of interest. NF has no conflicts of interest. TAZ reports research grants from the Austrian Science Funds, and Boehringer Ingelheim; honoraria for serving on advisory boards from Boehringer Ingelheim and Bayer AG; personal fees from Alkem Lab. Ltd, AstraZeneca, Bayer AG, Boehringer Ingelheim, and Sun Pharmaceutical Industries, and educational grants from Eli Lilly and Company. MPR has no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare the following financial interests\/personal relationships which may be considered as potential competing interests: TAZ reports research grants from the Austrian Science Funds, and Boehringer Ingelheim; honoraria for serving on advisory boards from Boehringer Ingelheim and Bayer AG; personal fees from Alkem Lab. Ltd, AstraZeneca, Bayer AG, Boehringer Ingelheim and Sun Pharmaceutical Industries and educational grants from Eli Lilly and Company. All other authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.","order":2,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}