open access

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Original article
Published online: 2021-05-31
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Is cytisine contraindicated in smoking patients with coronary artery disease after percutaneous coronary intervention?

Bogumił Ramotowski, Andrzej Budaj
DOI: 10.33963/KP.a2021.0025
·
Pubmed: 34060636

open access

Online first
Original article
Published online: 2021-05-31

Abstract

Background: Cytisine is contraindicated and its effects have not been evaluated in patients with coronary artery disease (CAD).
Aim: The safety, feasibility and short-term efficacy of cytisine for smoking cessation were evaluated in active smokers with CAD after percutaneous coronary interventions (PCI).
Methods: Patients with stable CAD and acute coronary syndromes (ACS), who smoked at least 10 cigarettes per day, were included 30 days post PCI and offered cytisine therapy. Adverse events, smoking activity and drug adherence were assessed after 30 days.
Results: 117 patients participated (mean standard deviation [SD] age, 60.8 [7.7] years; men, 73.6%, mean [SD] number of pack-years 39.1 [13.9]). Overall, 79 patients consented (study group) and 38 declined (control group) to use cytisine. At follow-up visit the incidence of adverse events did not differ between groups (17.7% vs 21%; P = 0.67). The groups had similar success rate of smoking cessation in the intention-to-treat analysis (41.8% vs 36.8%; P = 0.61). In as treated analysis, patients who completed the therapy achieved a higher success rate than patients who declined (69.7% vs 36.9%; P = 0.006) or did not complete therapy (69.7% vs 34.8%; P = 0.01). In the multivariable analysis, complete cytisine therapy and ACS at admission were associated with an increased and male sex with decreased chance of smoking cessation.
Conclusion: Cytisine therapy is not associated with an increase in adverse events in patients with CAD after PCI. Cytisine is tolerable but effective in short-term follow-up only when the treatment is completed.

Abstract

Background: Cytisine is contraindicated and its effects have not been evaluated in patients with coronary artery disease (CAD).
Aim: The safety, feasibility and short-term efficacy of cytisine for smoking cessation were evaluated in active smokers with CAD after percutaneous coronary interventions (PCI).
Methods: Patients with stable CAD and acute coronary syndromes (ACS), who smoked at least 10 cigarettes per day, were included 30 days post PCI and offered cytisine therapy. Adverse events, smoking activity and drug adherence were assessed after 30 days.
Results: 117 patients participated (mean standard deviation [SD] age, 60.8 [7.7] years; men, 73.6%, mean [SD] number of pack-years 39.1 [13.9]). Overall, 79 patients consented (study group) and 38 declined (control group) to use cytisine. At follow-up visit the incidence of adverse events did not differ between groups (17.7% vs 21%; P = 0.67). The groups had similar success rate of smoking cessation in the intention-to-treat analysis (41.8% vs 36.8%; P = 0.61). In as treated analysis, patients who completed the therapy achieved a higher success rate than patients who declined (69.7% vs 36.9%; P = 0.006) or did not complete therapy (69.7% vs 34.8%; P = 0.01). In the multivariable analysis, complete cytisine therapy and ACS at admission were associated with an increased and male sex with decreased chance of smoking cessation.
Conclusion: Cytisine therapy is not associated with an increase in adverse events in patients with CAD after PCI. Cytisine is tolerable but effective in short-term follow-up only when the treatment is completed.

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Keywords

coronary artery disease, cytisine, Fagerström index, NicAlert test, smoking cessation

About this article
Title

Is cytisine contraindicated in smoking patients with coronary artery disease after percutaneous coronary intervention?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-05-31

DOI

10.33963/KP.a2021.0025

Pubmed

34060636

Keywords

coronary artery disease
cytisine
Fagerström index
NicAlert test
smoking cessation

Authors

Bogumił Ramotowski
Andrzej Budaj

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