Comparison of Cardiovascular Safety for Smoking Cessation Pharmacotherapies in a Population-Based Cohort in Australia

Source:

Havard A, Choi SKY, Pearson S, Chow CK, Tran DT, Filion KB. Comparison of Cardiovascular Safety for Smoking Cessation Pharmacotherapies in a Population-Based Cohort in Australia. JAMA Netw Open. 2021;4(11):e2136372. doi:10.1001/jamanetworkopen.2021.36372

Key Points

Question  What is the relative cardiovascular safety of the smoking cessation pharmacotherapies varenicline, nicotine replacement therapy (NRT) patches, and bupropion?

Findings  In this cohort study of 342 064 varenicline and 10 457 bupropion initiators, 122 932 varenicline and 92 148 NRT patch initiators, and 102 817 NRT patch and 6056 bupropion initiators residing in New South Wales, Australia, no difference in the risk of major adverse cardiovascular events was found between the use of varenicline and NRT patches. The results of the comparisons for risk of major adverse cardiovascular events in the use of varenicline or NRT patches with the use of bupropion were inconclusive.

Meaning  Findings from this cohort study suggest that varenicline, the most efficacious of the smoking cessation pharmacotherapies, may be prescribed in preference to NRT patches without increasing risk of major cardiovascular events.