Clinical Outcomes After Treatment of Cocaine-Induced Chest Pain with Beta-Blockers: A Systematic Review and Meta-Analysis

Kevin Bryan Lo, Hafeez Ul Hassan Virk, Vladimir Lakhter, Pradhum Ram, Carlos Gongora, Gregg Pressman, Vincent Figueredo

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Recent guidelines have suggested avoiding beta-blockers in the setting of cocaine-associated acute coronary syndrome. However, the available evidence is both scarce and conflicted. The purpose of this systematic review and meta-analysis is to investigate the evidence pertaining to the use of beta-blockers in the setting of acute cocaine-related chest pain and its implication on clinical outcomes. Methods: Electronic databases were systematically searched to identify literature relevant to patients with cocaine-associated chest pain who were treated with or without beta-blockers. We examined the end-points of in-hospital all-cause mortality and myocardial infarction. Pooled risk ratios (RR) and their 95% confidence intervals (CI) were calculated for all outcomes using a random-effects model. Results: Five studies with a total of 1447 patients were included. Our analyses found no differences between patients treated with or without beta-blockers for either myocardial infarction (RR 1.08; 95% CI, 0.61-1.91) or all-cause mortality (RR 0.75; 95% CI, 0.46-1.24). Heterogeneity among included studies was low to moderate. Conclusion: This systematic review and meta-analysis suggests that beta-blocker use is not associated with adverse clinical outcomes in patients presenting with acute chest pain related to cocaine use.

Original languageEnglish (US)
Pages (from-to)505-509
Number of pages5
JournalAmerican Journal of Medicine
Issue number4
StatePublished - Apr 2019
Externally publishedYes


  • Beta-blockers
  • Chest pain
  • Cocaine
  • Meta-analysis
  • Systematic review

ASJC Scopus subject areas

  • General Medicine


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