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Research Snapshot Theater: Sepsis, Adult I

Post-Onset β-Blocker Therapy Reduces Mortality in Sepsis-Induced Myocardial Injury

Sunday, March 22, 2026
9:45 AM - 10:45 AM Central Time
Location: Connections Central - RST 14

  • Zhao Wu, n/a

    Hunan, CHN

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • SZ

    Shuai Zhang, n/a

    student
    School of Computer Science and Engineering, Central South University, China (People's Republic)

    Disclosure information not submitted.

  • LZ

    Lina Zhang, n/a

    professor
    Xiangya Hospital, Central South University, China (People's Republic)

    Disclosure information not submitted.

  • YZ

    Yongmin Zhang, n/a

    professor
    School of Computer Science and Engineering, Central South University, China (People's Republic)

    Disclosure information not submitted.

Introduction: This study investigated the association between β-blocker therapy and clinical outcomes in sepsis-induced myocardial injury (SIMI) patients.


Methods: A multicenter retrospective cohort study utilized data from MIMIC-IV, eICU-CRD and Xiangya Hospital database. Patients were stratified into β-blocker and non-β-blocker groups. Primary outcome was 28-day mortality. The eICU-CRD and Xiangya could only compare in-hospital mortality due to data limitations. Propensity score matching (PSM) balanced baseline covariates. Survival analysis used Kaplan-Meier curves and Cox proportional hazards models.


Results: In MIMIC-IV, 2,491 SIMI patients were included (1,624 β-blocker, 867 non-β-blocker). After PSM, 867 pairs of patients were matched, with 28-day mortality of 18.45% in the β-blocker group and 32.53% in the non–β-blocker group(P < 0.001). Multivariate Cox regression analysis demonstrated that β-blocker was significantly associated with reduced mortality, including 28-day (hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.41–0.61, P < 0.001), 90-day (HR 0.55, 95% CI 0.47–0.66, P < 0.001) and 1-year mortality (HR 0.71, 95% CI 0.61–0.82, P < 0.001). Post-onset β-blocker therapy (n=791 PSM pairs) was associated with improved outcomes, including 28-day (HR 0.57, 95% CI 0.48–0.68, P < 0.001), 90-day (HR 0.60, 95% CI 0.51–0.70, P < 0.001) and 1-year mortality (HR 0.71, 95% CI 0.62–0.82, P < 0.001). However, premorbid β-blocker exposure (n=76 PSM pairs) did not reduce mortality, including 28-day (HR 1.37, 95% CI 0.82-2.30, P = 0.845), 90-day (HR 1.44, 95% CI 0.89-2.33, P = 0.141) and 1-year mortality (HR 1.58 , 95% CI 1.00-2.50, P = 0.049). Subgroups analysis showed that mortality reduction persisted across all subgroups, with significant interaction for hypertension (P < 0.05). In eICU-CRD (750 β-blocker, 1773 non-β-blocker), both before and after PSM, the β-blocker group exhibited lower in-hospital mortality(before PSM, 16.80% vs 20.36%; after PSM, 16.80% vs 20.93%). In Xiangya (120 β-blocker, 46 non-β-blocker), the β-blocker group also exhibited lower in-hospital mortality(8.33% vs 8.70%).


Conclusions: β-blocker therapy, particularly when initiated after sepsis onset, is associated with reduced short- and long-term mortality in SIMI patients. Premorbid β-blocker exposure did not improve survival.