Early metoprolol use in ICU patients with congestive heart failure is associated with increased 30-day mortality: a causal machine learning study

Early metoprolol use within 24 h of ICU admission in CHF patients is associated with increased 30-day mortality. Therapeutic effects were heterogeneous, with the adverse effects being particularly pronounced in patients with high APSIII, advanced age, elevated SOFA, high white blood cell counts, and elevated blood urea nitrogen levels. These findings suggest careful consideration should be given to the early use of metoprolol in high-risk patients.