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Bupropion for Smoking Cessation in Patients With Acute Coronary Syndrome.
MedLine Citation:
PMID:  21403011     Owner:  NLM     Status:  Publisher    
BACKGROUND: Smokers hospitalized with acute coronary syndrome (ACS) are at high risk for subsequent ischemic events. Nevertheless, over two-thirds of patients continue to smoke after an acute myocardial infarction. Bupropion hydrochloride has proven efficacy as a smoking cessation aid, but data regarding its safety and efficacy in ACS patients are limited. METHODS: In a double-blind, randomized controlled trial, we compared the safety and efficacy of 8 weeks of treatment with bupropion slow-release (SR) or placebo for smokers hospitalized with ACS as an adjunct to nurse-led hospital- and telephone-based support. Primary efficacy outcome was smoking abstinence at 1 year. Primary safety outcome was clinical events at 1 year. RESULTS: A total of 151 patients were enrolled; all but 2 completed follow-up. Abstinence rates at 3 months were 45% and 44% in the bupropion SR and placebo groups, respectively (P = .99); 37% vs 42% (P = .61) at 6 months; and 31% vs 33% (P = .86) at 1 year. On multivariate analysis, an invasive procedure performed during index hospitalization was an independent predictor for smoking abstinence at 1 year (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.22-14.19). Presence of adverse effects attributed to treatment was a negative predictor for smoking cessation (OR, 0.23; 95% CI, 0.07-0.78). Treatment with bupropion SR was not associated with an increase in clinical events or change in blood pressure or body mass index, but dizziness was more common compared with placebo (14% vs 1.4%; P = .005). CONCLUSION: In hospitalized patients with ACS who received continuous, intensive nurse counseling about smoking cessation, bupropion did not increase the rates of smoking abstinence.
David Planer; Ishay Lev; Yair Elitzur; Nir Sharon; Elisha Ouzan; Thea Pugatsch; Michal Chasid; Miri Rom; Chaim Lotan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-14
Journal Detail:
Title:  Archives of internal medicine     Volume:  -     ISSN:  1538-3679     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Ouzan, Pugatsch, and Lotan), Department of Family Medicine (Dr Lev), and Braun School of Public Health (Mr Sharon), Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Internal Medicine, Hadassah-Hebrew University Medical Centre, Mount Scopus Jerusalem, Israel (Dr Elitzur); and Hebrew University-Hadassah School of Nursing, Jerusalem (Ms Chasid and Dr Rom).
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