期刊
CIRCULATION
卷 129, 期 1, 页码 28-+出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.113.003961
关键词
bupropion; cardiovascular diseases; meta-analysis; smoking cessation; tobacco use cessation products; varenicline
资金
- Pfizer Inc [WS981308]
- Canadian Institutes of Health Research through a Canada Research Chair
- Canadian Institutes of Health Research via the Drug and Safety Evaluation Network to develop methods for assessing harms using network meta-analysis
- National Institute on Drug Abuse [P50 DA09253, R34DA030538]
- National Institute of Mental Health [R01 MH083684]
- State of California Tobacco-Related Disease Research Program [17RT-0077, 21BT-0018]
Background-Stopping smoking is associated with many important improvements in health and quality of life. The use of cessation medications is recommended to increase the likelihood of quitting. However, there is historical and renewed concern that smoking cessation therapies may increase the risk of cardiovascular disease events associated within the quitting period. We aimed to examine whether the 3 licensed smoking cessation therapies-nicotine replacement therapy, bupropion, and varenicline-were associated with an increased risk of cardiovascular disease events using a network meta-analysis. Methods and Results-We searched 10 electronic databases, were in communication with authors of published randomized, clinical trials (RCTs), and accessed internal US Food and Drug Administration reports. We included any RCT of the 3 treatments that reported cardiovascular disease outcomes. Among 63 eligible RCTs involving 21 nicotine replacement therapy RCTs, 28 bupropion RCTs, and 18 varenicline RCTs, we found no increase in the risk of all cardiovascular disease events with bupropion (relative risk [RR], 0.98; 95% confidence interval [CI], 0.54-1.73) or varenicline (RR, 1.30; 95% CI, 0.79-2.23). There was an elevated risk associated with nicotine replacement therapy that was driven predominantly by less serious events (RR, 2.29; 95% CI, 1.39-3.82). When we examined major adverse cardiovascular events, we found a protective effect with bupropion (RR, 0.45; 95% CI, 0.21-0.85) and no clear evidence of harm with varenicline (RR, 1.34; 95% CI, 0.66-2.66) or nicotine replacement therapy (RR, 1.95; 95% CI, 0.26-4.30). Conclusion-Smoking cessation therapies do not appear to raise the risk of serious cardiovascular disease events.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据