Researchers from Canada looked at the efficacy of varenicline in patients with the acute coronary syndrome to determine whether it would increase smoking abstinence. The randomized controlled trial included 302 patients at centres in Canada and the US who had been admitted to hospital for acute coronary syndrome, were motivated to quit smoking and who smoked at least 10 cigarettes a day for the previous year. Patients received smoking cessation counselling as well as either varenicline or a placebo control for 12 weeks. Most participants had moderate to severe nicotine dependency.
About 40% of participants who received varenicline were not smoking at one year, compared with 29% in the placebo group. Reductions in daily cigarette smoking of at least 50% were also higher in the varenicline group (57.8%) compared with the placebo group (49.7%). Rates of adverse events were similar in both groups.
“This suggests that varenicline is safe for use in these patients,” writes Dr. Mark Eisenberg, Jewish General Hospital and McGill University, Montreal, Quebec, with coauthors. “However, new strategies for smoking cessation are still needed, given that 60% of smokers who received treatment with varenicline returned to smoking by one year after their acute coronary syndrome.”
The authors note that if varenicline was used as routine treatment in smokers after the heart attack, it would reduce smoking in this group by about 10%.
Dr. Robert Reid, University of Ottawa Heart Institute and coauthors write, “Given the powerful effect of smoking cessation on subsequent cardiovascular morbidity and mortality, smoking cessation interventions including counselling and medications [such as varenicline], initiated in the hospital and integrated into post-discharge support, should be standard practice for patients with acute coronary syndrome receiving treatment at hospitals in Canada. Anything less reflects substandard care.”
“Smoking abstinence 1 year after acute coronary syndrome: follow-up from a randomized controlled trial of varenicline in patients admitted to hospital” is published March 26, 2018.
For more details click on the link:http://www.cmaj.ca/lookup/doi/10.1503/cmaj.180125