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Because of risk for unopposed α-adrenergic stimulation, β-blockers generally are thought to be contraindicated in patients who use cocaine. In a retrospective study, researchers evaluated whether use of β-blockers raised the rate of adverse outcomes in patients with chest pain and positive urine test results for cocaine. The 331 patients (mean age, 50; 26% with previously diagnosed coronary artery disease) were admitted to a San Francisco teaching hospital from 2001 to 2006; 46% received β-blockers in the emergency department.
No significant differences in troponin levels or electrocardiographic changes were observed between patients who received β-blockers and those who did not; however, only the β-blocker group experienced a significant re…