Association Between Preadmission β‐Blocker Use and Venoarterial Extracorporeal Membrane Oxygenation Weaning Failure in Patients With Cardiogenic Shock

Journal of the American Heart Association, Volume 15, Issue 11 , June 2, 2026. BackgroundPreadmission β‐blocker (BB) use may convey cardioprotective effects after onset of cardiogenic shock (CS).

It is unknown whether this also holds for patients with the most severe forms of CS receiving venoarterial extracorporeal membrane oxygenation (V‐A ECMO) support.MethodsWe conducted a multicenter observational cohort study including adult patients supported by V‐A ECMO for severe CS between February 2018 and January 2025. Patients who had taken BBs within 48 hours before ECMO initiation as part of their home medication were compared with those who had not.

The primary end point was ECMO weaning failure at 30 days; a composite of death, ongoing or renewed ECMO support, or the need for heart replacement therapy.ResultsA total of 307 patients were included in the study, of whom 87 (28.3%) were in the BB group. ECMO weaning failure occurred in 40 patients (46.0%) in the BB group compared with 126 (57.3%) patients in the non‐BB group (log‐rank test,P=0.08).