title: Bupropion for smoking cessation in patients with acute coronary syndrome.
abstract: BACKGROUND
  Smokers hospitalized with acute coronary syndrome (ACS) are at high risk for subsequent ischemic events. Nevertheless, over two-thirds of patients continue to smoke after an acute myocardial infarction. Bupropion hydrochloride has proven efficacy as a smoking cessation aid, but data regarding its safety and efficacy in ACS patients are limited.
  
  
  METHODS
  In a double-blind, randomized controlled trial, we compared the safety and efficacy of 8 weeks of treatment with bupropion slow-release (SR) or placebo for smokers hospitalized with ACS as an adjunct to nurse-led hospital- and telephone-based support. Primary efficacy outcome was smoking abstinence at 1 year. Primary safety outcome was clinical events at 1 year.
  
  
  RESULTS
  A total of 151 patients were enrolled; all but 2 completed follow-up. Abstinence rates at 3 months were 45% and 44% in the bupropion SR and placebo groups, respectively (P = .99); 37% vs 42% (P = .61) at 6 months; and 31% vs 33% (P = .86) at 1 year. On multivariate analysis, an invasive procedure performed during index hospitalization was an independent predictor for smoking abstinence at 1 year (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.22-14.19). Presence of adverse effects attributed to treatment was a negative predictor for smoking cessation (OR, 0.23; 95% CI, 0.07-0.78). Treatment with bupropion SR was not associated with an increase in clinical events or change in blood pressure or body mass index, but dizziness was more common compared with placebo (14% vs 1.4%; P = .005).
  
  
  CONCLUSIONS
  In hospitalized patients with ACS who received continuous, intensive nurse counseling about smoking cessation, bupropion did not increase the rates of smoking abstinence.
authors.affiliation: Heart Institute, Hadassah–Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Planer
authors.forename: Ishay
authors.initials: I
authors.lastname: Lev
authors.forename: Yair
authors.initials: Y
authors.lastname: Elitzur
authors.forename: Nir
authors.initials: N
authors.lastname: Sharon
authors.forename: Elisha
authors.initials: E
authors.lastname: Ouzan
authors.forename: Thea
authors.initials: T
authors.lastname: Pugatsch
authors.forename: Michal
authors.initials: M
authors.lastname: Chasid
authors.forename: Miri
authors.initials: M
authors.lastname: Rom
authors.forename: Chaim
authors.initials: C
authors.lastname: Lotan
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D016642:Bupropion / Q000627:therapeutic use*; D003376:Counseling; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018765:Dopamine Uptake Inhibitors; D016642:Bupropion