Dollerup J, et al. – This research entailed the determination of the cardiovascular risks in smokers treated with nicotine replacement therapy. The nicotine replacement therapy (NRT), over 4 weeks, did not exert any effect on cardiovascular risks. A longer follow–up period of 52 weeks, nevertheless, led to an increase in cardiovascular events for patients who were prescribed NRT, compared with those receiving smoking cessation advice only.

Methods

• Data was extracted from the United Kingdom’s Clinical Practice Research Datalink.
• The CVD events and survival were analyzed among individuals who attempted smoking cessation with the support of NRT compared with those aided by smoking cessation advice only.
• The CVD outcomes were evaluated over 4 and 52 weeks, in 50,214 smokers attempting to quit -33,476 supported by smoking cessation advice and 16,738 with the support of NRT prescribed by their primary care physician.
• Patients were matched (2 smoking cessation advice patients:1 NRT patient) on demographic and clinical characteristics during a baseline year preceding their quit attempt.
• Assessment of data was done via Cox proportional hazard regression, conditional negative binomial regression model, and conditional logistic regression.

Results

• Mean (standard deviation) population age was 47 (11.2) years; 51% were females.
• Similar time to first diagnosis of ischemic heart disease (IHD) among NRT and smoking cessation advice patients was noted within the first 4 weeks, but shorter for NRT patients over 52 weeks (hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.03-1.77).
• There displayed a similar trend for cerebrovascular disease (HR: 1.54, 95% CI: 1.08-2.19).
• NRT patients with a prior diagnosis of IHD or cerebrovascular disease reported a higher rate of primary or secondary care consultations for IHD or cerebrovascular disease by 52 weeks (rate ratio: 1.50, 95% CI: 1.14-1.99).
• Patients prescribed NRT exhibited a shorter survival time over 52 weeks, compared with those receiving advice only (HR: 1.39, 95% CI: 1.09-1.76).