| Nicotine patch therapy in smoking cessation reduces the extent of exercise-induced myocardial ischemia. | |
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MedLine Citation:
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PMID: 9207632 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to determine the effects of nicotine patch therapy, when used to promote smoking cessation, on myocardial ischemia in patients with coronary artery disease. BACKGROUND: Nicotine patches substantially increase quit rates among cigarette smokers, but their safety in patients with myocardial ischemia who are attempting to quit smoking is unknown. METHODS: This is a prospective study using exercise thallium-201 single-photon emission computed tomography (SPECT) to assess serial changes in the total and ischemic myocardial perfusion defect size at baseline while patients were smoking and during treatment with 14- and 21-mg nicotine patches. Entry criteria required that patients 1) smoked > or = 1 pack of cigarettes per day; 2) had known coronary artery disease; and 3) had myocardial ischemia (i.e., > or = 5% reversible perfusion defect) on SPECT. All patients performed symptom-limited treadmill exercise, and the baseline SPECT study served as its own control. We interpreted and computer quantified the SPECT images with no knowledge of the testing sequence. RESULTS: Thirty-six of the 40 enrolled patients had exercise SPECT at baseline and during treatment with at least 14-mg nicotine patches. These patients had an initial perfusion defect size of 17.5 +/- 10.6% while smoking an average of 31 +/- 11 cigarettes per day for 40 +/- 12 years. A significant reduction in the total perfusion defect size (p < 0.001) was observed from baseline (17.5 +/- 10.6%) to treatment with 14-mg (12.6 +/- 10.1%) and 21-mg (11.8 +/- 9.9%) nicotine patches. This reduction occurred despite an increase in treadmill exercise duration (p < 0.05) and higher serum nicotine levels (p < 0.001). There was a significant correlation between the reduction in defect size and exhaled carbon monoxide levels (p < 0.001) because patients reduced their smoking by approximately 74% during the trial. CONCLUSIONS: Nicotine patches, when used to promote smoking cessation, significantly reduce the extent of exercise-induced myocardial ischemia as assessed by exercise thallium-201 SPECT. |
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Authors:
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J J Mahmarian; L A Moyé; G A Nasser; S F Nagueh; M F Bloom; N L Benowitz; M S Verani; W G Byrd; C M Pratt |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 30 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1997 Jul |
Date Detail:
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Created Date: 1997-07-15 Completed Date: 1997-07-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 125-30 Citation Subset: AIM; IM |
Affiliation:
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Section of Cardiology, Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA. johnj@bcm.tmc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Cutaneous Coronary Disease / complications*, radionuclide imaging Exercise Test Female Humans Linear Models Male Middle Aged Multivariate Analysis Myocardial Ischemia / etiology, prevention & control*, radionuclide imaging Nicotine / administration & dosage* Pilot Projects Prospective Studies Smoking / adverse effects, therapy Smoking Cessation / methods* Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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54-11-5/Nicotine |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 1997 Jul;30(1):131-2
[PMID:
9207633
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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