Bupropion for Smoking Cessation in Patients With Acute Coronary Syndrome

Planer, David; Lev, Ishay; Elitzur, Yair; Sharon, Nir; Ouzan, E.; Pugatsch, Thea; Chasid, Michal; Rom, Miri; Lotan, Chaim

doi:10.1001/archinternmed.2011.72

Cited by 62 publications

(51 citation statements)

References 31 publications

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“…Our results are important, because clinical trials have not examined the efficacy of nicotine replacement therapy in this patient population and because several trials of bupropion in these patients suggest that it is not efficacious. [5][6][7] The benefits of smoking cessation in patients with cardiovascular disease should not be underestimated. Multiple studies have demonstrated substantial reductions in both morbidity and mortality among patients with cardiovascular disease who are able to stop smoking.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Smoking cessation is of critical importance in these patients, yet less than a third of smokers who experience an ACS are able to remain abstinent following hospital discharge. [5][6][7] Few randomized controlled trials have examined the efficacy of smoking cessation pharmacotherapies in hospitalized patients with ACS, despite the substantial benefits of quitting in this population. In-hospital initiation of nicotine replacement therapy, although frequently prescribed in North America, has not been examined in randomized controlled trials.…”

mentioning

confidence: 99%

“…Bupropion, a non-nicotine replacement therapy, was tested in 3 trials and was found not to be efficacious. [5][6][7] Varenicline is an α4β2 nicotinic acetylcholine receptor partial agonist that reduces cravings and withdrawal symptoms during smoking abstinence and also decreases the reinforcing effects of nicotine. 8 Although varenicline has been shown to be effective for smoking cessation in both healthy smokers and patients with stable cardiovascular disease, [9][10][11] little is known about its efficacy in patients with acute cardiovascular disease.…”

mentioning

confidence: 99%

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Varenicline for Smoking Cessation in Hospitalized Patients With Acute Coronary Syndrome

et al. 2016

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Background-Less than one-third of smokers hospitalized with an acute coronary syndrome (ACS) remain abstinent following discharge. We assessed whether varenicline, begun in-hospital, is efficacious for smoking cessation following ACS. Methods and Results-We conducted a multi-center, double-blind, randomized, placebo-controlled trial in which smokers hospitalized with an ACS were randomized to varenicline or placebo for 12 weeks. All patients received low-intensity counseling. The primary end point was point-prevalence smoking abstinence assessed at 24 weeks by 7-day recall and biochemical validation using expired carbon monoxide. A total of 302 patients were randomized (mean age 55±9 years; 75% male; 56% ST-segment elevation myocardial infarction; 38% non-ST-segment elevation myocardial infarction; 6% unstable angina). Patients smoked a mean of 21±11 cigarettes/d at the time of hospitalization and had been smoking for a mean of 36±12 years. At 24 weeks, patients randomized to varenicline had significantly higher rates of smoking abstinence and reduction than patients randomized to placebo. Point-prevalence abstinence rates were 47.3% in the varenicline group and 32.5% in the placebo group (P=0.012; number needed to treat=6.8). Continuous abstinence rates were 35.8% and 25.8%, respectively (P=0.081; number needed to treat=10.0), and rates of reduction ≥50% in daily cigarette consumption were 67.4% and 55.6%, respectively (P=0.05; number needed to treat=8.5). Adverse event rates within 30 days of study drug discontinuation were similar between groups (serious adverse events: varenicline 11.9%, placebo 11.3%; major adverse cardiovascular events: varenicline 4.0%, placebo 4.6%). Conclusions

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Varenicline for Smoking Cessation in Hospitalized Patients With Acute Coronary Syndrome

et al. 2016

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“…305 Bupropion is generally well tolerated and has been shown to be safe to use in the immediate period after MI. 310,311 Among 629 patients with cardiovascular disease, a 7-week treatment with bupropion resulted in twice as many smokers quitting at 1 year compared with placebo. 312 Varenicline has also been shown to be effective in reducing rates of smoking.…”

Section: Smoking Cessationmentioning

confidence: 99%

Secondary Prevention After Coronary Artery Bypass Graft Surgery

Kulik¹,

Ruel²,

Jneid³

et al. 2015

Circulation

346

185

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“…'nın 28 merkezi kapsayan ve kardiyovasküler hastalığı olan 629 hastayı kapsayan çalışmalarında, bir yılın sonunda bupropion kullanan grupta plaseboya göre bırakma oranı açısından iki kat fark saptanmıştır (39) . Bupropion ile yapılan çalışmalarda plasebo ile karşılaştırıldığında kardiyovasküler yan etki riskinde artış izlenmemiş-tir (40)(41)(42)(43) . Bupropionun ancak yüksek doz alınımında aritmi yaptığı vaka çalışmalarında gösterilmiştir (44,45) .…”

Section: Kardiyovasküler Hastalıklarunclassified