Varenicline Effective for Smoking Cessation After Heart Attack

Varenicline is safe and effective for smoking cessation through 52 weeks of use among patients with acute coronary syndrome (ACS), according to a recent study.

In the EVITA trial, researchers assessed 302 participants who were hospitalized for ACS. Each participant was randomly assigned to 12-week smoking cessation treatment with varenicline or placebo, along with low-intensity counseling.
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Seven-day recall was used to evaluate smoking abstinence, and biochemical validation was performed using exhaled carbon monoxide.

Smoking abstinence rates decreased as the trial progressed. Approximately 34.4% of participants were still abstinent at 52 weeks post-ACS.

Based on estimates, varenicline use vs placebo was likely associated with increased point-prevalence abstinence (39.9% vs 29.1%), continuous abstinence (31.1% vs 21.2%), and reduction in cigarette smoking by 50% or more (57.8% vs 49.7%)

Similar rates of adverse events (24.5% vs 21.9%; risk difference: 2.7%) and major adverse cardiovascular events (8.6% vs 9.3%) were observed between groups.

“Varenicline was efficacious for smoking cessation in this high-risk patient population,” the researchers concluded. “However, 60% of patients who received treatment with varenicline still returned to smoking.”

—Christina Vogt

Reference:

Windle SB, Dehghani P, Roy N, et al. Smoking abstinence 1 year after acute coronary syndrome: follow-up from a randomized controlled trial of varenicline in patients admitted to hospital. CMAJ. 2018;190(12):E347-E354. https://doi.org/10.1503/cmaj.170377.