Document Detail


Nicotine patch therapy in smoking cessation reduces the extent of exercise-induced myocardial ischemia.
MedLine Citation:
PMID:  9207632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  1997-07-15     Completed Date:  1997-07-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  125-30     Citation Subset:  AIM; IM    
Affiliation:
Section of Cardiology, Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA. johnj@bcm.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
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:
54-11-5/Nicotine
Comments/Corrections
Comment In:
J Am Coll Cardiol. 1997 Jul;30(1):131-2   [PMID:  9207633 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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