PMID- 36822209
OWN - NLM
STAT- MEDLINE
DCOM- 20230508
LR  - 20230911
IS  - 1533-4023 (Electronic)
IS  - 0160-2446 (Linking)
VI  - 81
IP  - 5
DP  - 2023 May 1
TI  - A Retrospective Review of Cardiogenic Shock Development in Patients With 
      ST-Elevation Myocardial Infarction and Percutaneous Coronary Intervention 
      Receiving Early Beta-Blockers.
PG  - 355-360
LID - 10.1097/FJC.0000000000001412 [doi]
AB  - Beta-blockers (BBs) have proven to improve morbidity and mortality in patients 
      after an ST elevation myocardial infarction (STEMI). Guidelines suggest 
      initiating a BB within 24 hours, except in those with risk factors for developing 
      cardiogenic shock, although published literature is conflicting regarding the 
      true association of these risk factors with shock. This retrospective cohort 
      study aimed to assess whether the presence of defined risk factors was associated 
      with cardiogenic shock after early BB administration in patients with a STEMI and 
      percutaneous coronary intervention. The primary outcome determined the rate of 
      cardiogenic shock development and secondarily determined any characteristics 
      associated with cardiogenic shock in patients who received beta blockers. The 
      population included 299 patients and cardiogenic shock occurred in 8 patients 
      (2.7%). There were no median (interquartile range) differences in age [63 years 
      (60-71) versus 62 years (52-71); P = 0.4965], systolic blood pressure [110 mm Hg 
      (105-115) versus 109 mm Hg (103-114); P = 0.6027], or heart rate [90 (78-104) 
      versus 76 (64-90); P = 0.0697] before BB administration in patients who developed 
      shock versus those who did not, respectively. Hours to BB administration from 
      arrival [15.6 (6.0-54.8) versus 21.9 (10.6-42; P = 0.6968] and the number (%) 
      with anterior infarction [3 (37.5%) versus 107 (36.8%); P = 1.000] were similar 
      between groups. There was a statistically significant higher median 
      (interquartile range) peak troponin [140 ng/mL (54-304) versus 49 ng/mL (16-132); 
      P = 0.0354] in patients who developed shock. Early initiation of a BB in patients 
      with STEMI and percutaneous coronary intervention with risk factors for 
      cardiogenic shock does not seem to be associated with shock in most patients.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Lacoursiere, Lauren
AU  - Lacoursiere L
AD  - University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, 
      NY; and.
AD  - Buffalo General Medical Center, Buffalo, NY.
FAU - Woodruff, Ashley E
AU  - Woodruff AE
AD  - University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, 
      NY; and.
AD  - Buffalo General Medical Center, Buffalo, NY.
FAU - Mills, Kevin
AU  - Mills K
AD  - University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, 
      NY; and.
AD  - Buffalo General Medical Center, Buffalo, NY.
FAU - Chilbert, Maya R
AU  - Chilbert MR
AUID- ORCID: 0000-0003-3183-5214
AD  - University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, 
      NY; and.
AD  - Buffalo General Medical Center, Buffalo, NY.
LA  - eng
PT  - Journal Article
DEP - 20230501
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Shock, Cardiogenic/diagnosis/drug therapy
MH  - *ST Elevation Myocardial Infarction/diagnosis/therapy
MH  - Retrospective Studies
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Risk Factors
MH  - Treatment Outcome
COIS- The authors report no conflicts of interest.
EDAT- 2023/02/24 06:00
MHDA- 2023/05/08 10:17
CRDT- 2023/02/23 19:03
PHST- 2022/10/22 00:00 [received]
PHST- 2023/01/25 00:00 [accepted]
PHST- 2023/05/08 10:17 [medline]
PHST- 2023/02/24 06:00 [pubmed]
PHST- 2023/02/23 19:03 [entrez]
AID - 00005344-202305000-00006 [pii]
AID - 10.1097/FJC.0000000000001412 [doi]
PST - epublish
SO  - J Cardiovasc Pharmacol. 2023 May 1;81(5):355-360. doi: 
      10.1097/FJC.0000000000001412.