Study Shows Bupropion Did Not Improve Smoking Cessation Rates Among AMI Patients in Moderate Sized Study
According to an article published on Jan. 28 in the Journal of the American College of Cardiology, bupropion does not improve smoking cessation rates among patients hospitalized with acute myocardial infarction (AMI), and nearly two-thirds of patients treated with bupropion resumed smoking within one year of hospitalization.
The authors add that two-thirds of patients return to smoking within one year after AMI. They also found that "bupropion is well tolerated and seems to be safe in the immediate post-AMI period;" however, "bupropion is not effective for smoking cessation in patients post-AMI." "These results suggest that smoking remains a major issue in the patient population with AMI," they add.
In an accompanying editorial, Neal L. Benowitz, MD, University of California, San Francisco, and Judith Prochaska, PhD, MPH, Stanford University, Palo Alto, Calif., note that although bupropion did not improve smoking abstinence rates at one year, there was a substantial reduction in the average daily cigarette intake from 22.8 to 8.4 in both groups, suggesting a high level of motivation among post-AMI patients. The editorial also noted that smoking cessation among hospitalized patients is notoriously difficult, as these patients have often smoked for many years, and have continued to smoke even with the onset of chronic diseases and risk factors for acute cardiovascular events. They also point out that had the study reached its plan enrollment of 1,500 patients, the treatment differences would have achieved statistical significance.
"The standard of care for managing patients after myocardial infarction should include not only blood pressure and lipid management but also smoking cessation," write Benowitz and Prochaska. "Increasing quit rates will likely require a combination of counseling and personalized medications, with a chronic disease-management approach," they add.
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