Cardiovascular disease (CVD) is a collective term referring to a group of diseases affecting the heart and blood vessels including: ischemic heart disease, stroke, peripheral vascular disease, heart failure, rheumatic heart disease, and congenital heart disease. Tobacco smoking is an important modifiable risk factor for cardiovascular events and Canadian and international clinical practice guidelines unanimously recommend smoking cessation for patients with CVD. Strategies for health care professionals who are assisting patients attempting to quit smoking can include counseling and the use of pharmacotherapy. Commonly used pharmacotherapy for smoking cessation includes nicotine replacement therapy (NRT), bupropion hydrochloride (Zyban), and varenicline tartrate (Champix). CADTH has conducted a health technology assessment which evaluated the clinical and cost-effectiveness of pharmacologic-based strategies for smoking cessation.9 Patients with CVD and smoking-related diseases were a subpopulation of interest in the CADTH review. The report suggested that nicotine gum, nicotine patch, bupropion, and varenicline were efficacious as an aid for smoking cessation compared with placebo for this patient population; however, harms data were not assessed in the review. In addition, Canadian and international regulatory agencies have recently updated the safety information for varenicline to include a warning regarding a potential increase in the risk of cardiovascular events in patents with CVD. The present review was conducted to summarize the available safety evidence for varenicline, bupropion, and NRT in patients with CVD. A search for evidence-based guidelines and recommendations on the use of these agents was also conducted to provide information regarding current practice.
- Pages
- 30
- Published in
- Canada
