Document Detail

Bupropion for smoking cessation in patients hospitalized with acute myocardial infarction: a randomized, placebo-controlled trial.
MedLine Citation:
PMID:  23369417     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to examine smoking cessation rates among smokers with AMI to determine whether bupropion, started in-hospital, is safe and can improve cessation rates at 1 year.
BACKGROUND: Bupropion doubles quit rates in otherwise healthy smokers and patients with stable cardiovascular disease. Although 2 previous trials examined the use of bupropion in patients hospitalized with acute cardiovascular disease, these studies have been inconclusive with respect to its safety and efficacy in patients with acute myocardial infarction (AMI).
METHODS: We conducted a multicenter, double-blind, placebo-controlled, randomized trial in smokers hospitalized with AMI. Participants received bupropion or placebo for 9 weeks and were followed for 12 months. Both groups received low-intensity counseling. Point prevalence abstinence was assessed by 7-day recall and biochemical validation of expired carbon monoxide.
RESULTS: A total of 392 patients were randomized (mean age 53.9 ± 10.3 years); 83.5% were male; 64.9% had ST-segment elevation myocardial infarction). Patients smoked a mean of 23.2 ± 10.6 cigarettes/day for a mean of 32.9 ± 12.4 years. At 12 months, point prevalence abstinence rates were 37.2% in the bupropion group and 32.0% in the placebo group (p = 0.33; % difference after adjusting for between center differences 3.9%). Continuous abstinence rates were 26.8% and 22.2%, respectively (p = 0.34). Major adverse cardiac event rates were similar (13.0% vs. 11.0%, respectively; p = 0.64).
CONCLUSIONS: Two-thirds of patients return to smoking by 12 months after AMI. Bupropion is well tolerated and seems to be safe to use in the immediate post-AMI period. However, bupropion is not effective for smoking cessation in patients post-AMI.
Mark J Eisenberg; Sonia M Grandi; André Gervais; Jennifer O'Loughlin; Gilles Paradis; Stéphane Rinfret; Nizal Sarrafzadegan; Sat Sharma; Claude Lauzon; Rakesh Yadav; Louise Pilote;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  61     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-01     Completed Date:  2013-03-25     Revised Date:  2013-04-02    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-32     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, Montreal, Quebec City, Canada.
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MeSH Terms
Bupropion / therapeutic use*
Double-Blind Method
Follow-Up Studies
Hospitalization / trends*
Middle Aged
Myocardial Infarction / drug therapy*,  epidemiology
Smoking / drug therapy*,  epidemiology,  trends*
Smoking Cessation / methods*
Treatment Outcome
Grant Support
NCT64989//Canadian Institutes of Health Research
Reg. No./Substance:
Comment In:
J Am Coll Cardiol. 2013 Feb 5;61(5):533-5   [PMID:  23369418 ]
Nat Rev Cardiol. 2013 Mar;10(3):117   [PMID:  23399973 ]

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