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Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease

BACKGROUND: Little is known about the safety of nicotine replacement therapy (NRT) in smokers hospitalized with coronary heart disease. METHODS AND RESULTS: We examined the short‐term safety of NRT use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse...

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Autores principales: Pack, Quinn R., Priya, Aruna, Lagu, Tara C., Pekow, Penelope S., Atreya, Auras, Rigotti, Nancy A., Lindenauer, Peter K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222950/
https://www.ncbi.nlm.nih.gov/pubmed/30371184
http://dx.doi.org/10.1161/JAHA.118.009424
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author Pack, Quinn R.
Priya, Aruna
Lagu, Tara C.
Pekow, Penelope S.
Atreya, Auras
Rigotti, Nancy A.
Lindenauer, Peter K.
author_facet Pack, Quinn R.
Priya, Aruna
Lagu, Tara C.
Pekow, Penelope S.
Atreya, Auras
Rigotti, Nancy A.
Lindenauer, Peter K.
author_sort Pack, Quinn R.
collection PubMed
description BACKGROUND: Little is known about the safety of nicotine replacement therapy (NRT) in smokers hospitalized with coronary heart disease. METHODS AND RESULTS: We examined the short‐term safety of NRT use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse sample of US hospitals in the year 2014. We compared smokers who started NRT in the first 2 days of hospitalization with smokers without any exposure to NRT and adjusted for baseline differences through propensity score matching. Outcomes included inpatient mortality, hospital length of stay, and 1‐month readmission. From 270 hospitals, we included 27 459 smokers (mean age, 58 years; 69% men; 56.9% in intensive care unit), of whom 4885 (17.8%) received NRT (97.2% used the nicotine patch, at a median dose of 21 mg/d for 3 days). After propensity matching, covariates were well balanced within each patient group. Among patients with myocardial infarction, compared with patients who did not receive NRT, those who received NRT showed no difference in mortality (2.1% versus 2.3%; P=0.98), mean length of stay (4.4±3.5 versus 4.3±3.3 days; P=0.60), or 1‐month readmission (15.8% versus 14.6%; P=0.31). Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery. CONCLUSIONS: Among smokers hospitalized for treatment of coronary heart disease, use of NRT was not associated with any differences in short‐term outcomes. Given the known beneficial effects of NRT in treating nicotine withdrawal, reducing cravings, and promoting smoking cessation after discharge, our findings suggest that NRT is a safe and reasonable treatment option.
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spelling pubmed-62229502018-11-19 Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease Pack, Quinn R. Priya, Aruna Lagu, Tara C. Pekow, Penelope S. Atreya, Auras Rigotti, Nancy A. Lindenauer, Peter K. J Am Heart Assoc Original Research BACKGROUND: Little is known about the safety of nicotine replacement therapy (NRT) in smokers hospitalized with coronary heart disease. METHODS AND RESULTS: We examined the short‐term safety of NRT use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse sample of US hospitals in the year 2014. We compared smokers who started NRT in the first 2 days of hospitalization with smokers without any exposure to NRT and adjusted for baseline differences through propensity score matching. Outcomes included inpatient mortality, hospital length of stay, and 1‐month readmission. From 270 hospitals, we included 27 459 smokers (mean age, 58 years; 69% men; 56.9% in intensive care unit), of whom 4885 (17.8%) received NRT (97.2% used the nicotine patch, at a median dose of 21 mg/d for 3 days). After propensity matching, covariates were well balanced within each patient group. Among patients with myocardial infarction, compared with patients who did not receive NRT, those who received NRT showed no difference in mortality (2.1% versus 2.3%; P=0.98), mean length of stay (4.4±3.5 versus 4.3±3.3 days; P=0.60), or 1‐month readmission (15.8% versus 14.6%; P=0.31). Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery. CONCLUSIONS: Among smokers hospitalized for treatment of coronary heart disease, use of NRT was not associated with any differences in short‐term outcomes. Given the known beneficial effects of NRT in treating nicotine withdrawal, reducing cravings, and promoting smoking cessation after discharge, our findings suggest that NRT is a safe and reasonable treatment option. John Wiley and Sons Inc. 2018-09-07 /pmc/articles/PMC6222950/ /pubmed/30371184 http://dx.doi.org/10.1161/JAHA.118.009424 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Pack, Quinn R.
Priya, Aruna
Lagu, Tara C.
Pekow, Penelope S.
Atreya, Auras
Rigotti, Nancy A.
Lindenauer, Peter K.
Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title_full Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title_fullStr Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title_full_unstemmed Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title_short Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
title_sort short‐term safety of nicotine replacement in smokers hospitalized with coronary heart disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222950/
https://www.ncbi.nlm.nih.gov/pubmed/30371184
http://dx.doi.org/10.1161/JAHA.118.009424
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