ArticleFrontiers in pharmacology2025
Impact of early β-blocker use on the incidence of sepsis and clinical outcomes following cardiac surgery: a retrospective cohort study.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.Scientific reports · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Sepsis after cardiac surgery represents a severe perioperative complication with high incidence and mortality rates. While the cardioprotective benefits of β-blocker following cardiac surgery are widely recognized, their impact on sepsis development remains unclear. This study aims to investigate the association between early postoperative β-blocker use and the incidence of sepsis, as well as clinical outcomes, in patients undergoing cardiac surgery. Methods: The analysis incorporated data from the MIMIC-IV database, with confounding factors addressed through propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and overlap weighting (OW). Logistic regression models assessed the risk of sepsis and in-hospital mortality, while Cox proportional hazards models evaluated 28-day and 1-year mortality. Kaplan-Meier survival curves and log-rank tests compared survival between groups. Sensitivity analyses using Fine-Gray competing risk models and cumulative incidence functions were performed. Subgroup analyses explored heterogeneity of treatment effects, and metoprolol was further stratified by dose to assess dose-response relationships. Results: A total of 3,154 patients treated with β-blocker and 5,220 controls were included. Early β-blocker use was associated with a reduced risk of sepsis and lower in-hospital mortality across all methods. For 28-day and 1-year mortality, β-blocker use showed a trend toward risk reduction. Competing risk analyses demonstrated lower cumulative incidence of sepsis in the β-blocker group. Subgroup and dose-response analyses indicated that both low and high doses of metoprolol were associated with reduced postoperative sepsis risk and mortality outcomes. Conclusion: Early use of β-blocker after cardiac surgery was associated with a lower incidence of sepsis, with potential benefits observed in both short-term and long-term prognosis. These findings provide valuable evidence for optimizing perioperative drug management strategies.
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