Effect of Esmolol on Clinical Outcomes in Critically Ill Patients: Data from the MIMIC-IV Database

• Published in: Journal of cardiovascular pharmacology and therapeutics 2023-01, Vol.28, p.10742484231185985-10742484231185985
• Main Authors: Liang, Qihong, Li, Lulan, Chen, Kerong, An, Sheng, Deng, Zhiya, Li, Jiaxin, Zhou, Shiyu, Chen, Zhongqing, Zeng, Zhenhua, An, Shengli
• Format: Article
• Language: English
• ISSN: 1074-2484; 1940-4034
• DOI: 10.1177/10742484231185985

Background and aims Esmolol is a common short-acting drug to control ventricular rate. This study aimed to evaluate the association between use of esmolol and mortality in critically ill patients. Methods This is a retrospective cohort study from MIMIC-IV database containing adult patients with a heart rate of over 100 beats/min during the intensive care unit (ICU) stay. Multivariable Cox proportional hazard models and logistic regression were used to explore the association between esmolol and mortality and adjust confounders. A 1:1 nearest neighbor propensity score matching (PSM) was performed to minimize potential cofounding bias. The comparison for secondary outcomes was performed at different points of time using an independent t-test. Results A total of 30,332 patients were reviewed and identified as critically ill. There was no significant difference in 28-day mortality between two groups before (HR = 0.90, 95% CI = 0.73-1.12, p = 0.343) and after PSM (HR = 0.84, 95% CI = 0.65-1.08, p = 0.167). Similar results were shown in 90-day mortality before (HR = 0.93, 95% CI = 0.75-1.14, p = 0.484) and after PSM (HR = 0.85, 95% CI = 0.67-1.09, p = 0.193). However, esmolol treatment was associated with higher requirement of vasopressor use before (HR = 2.89, 95% CI = 2.18-3.82, p