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#ICD 10 S/P CAD PATCH#
The comparison of 122 932 varenicline initiators and 92 148 NRT patch initiators showed no difference in the risk of MACE (HR, 0.87 95% CI, 0.72-1.07) nor in the risk of the secondary outcomes of acute coronary syndrome (HR, 0.96 95% CI, 0.76-1.21) and stroke (HR, 0.72 95% CI, 0.45-1.14). Data were analyzed January 24, 2019, to September 1, 2021. Cox proportional hazards regression models with robust variance were used to estimate hazard ratios (HRs) and 95% CIs. Inverse probability of treatment weighting with high-dimensional propensity scores was used to account for potential confounding. Secondary outcomes were the individual components of MACE. Main Outcomes and Measures The primary outcome was MACE, defined as a composite of acute coronary syndrome, stroke, and cardiovascular death. Pairwise comparisons were conducted for risk of MACE among 122 932 varenicline vs 92 148 NRT initiators 342 064 varenicline vs 10 457 bupropion initiators and 102 817 NRT vs 6056 bupropion initiators.Įxposure First course of the smoking cessation pharmacotherapy of interest.
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Participants included adults who were dispensed a prescription smoking cessation pharmacotherapy between 20 or between 20, depending on the availability of the pharmacotherapies being compared. Objective To compare the risk of major adverse cardiovascular events (MACE) among individuals initiating varenicline, nicotine replacement therapy (NRT) patches, or bupropion.ĭesign, Setting, and Participants This retrospective, population-based cohort study using linked pharmaceutical dispensing, hospital admissions, and death data was conducted in New South Wales, Australia. In the interest of minimizing risk to patients, prescribers need evidence indicating how these pharmacotherapies compare with one another in terms of cardiovascular safety. Importance Although concerns exist regarding a potential increased risk of cardiovascular events for smoking cessation pharmacotherapies, there is general consensus that any increased risk associated with their use would be outweighed by the benefits of smoking cessation thus, clinical guidelines recommend that such pharmacotherapies be offered to everyone who wants to quit smoking.
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Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.High-Dimensional Propensity Score Distribution Among Smoking Cessation Pharmacotherapy Initiators Before and After Weighting Hazard Ratios for All-Cause Death Outcome Associated With Smoking Cessation Pharmacotherapy Initiation, for Each Pairwise ComparisonĮFigure.
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Hazard Ratios for MACE Associated With Smoking Cessation Pharmacotherapy Initiation, Among Patients With a History of Cardiovascular DiseaseĮTable 8. Hazard Ratios for Cardiovascular Outcomes Associated With Smoking Cessation Pharmacotherapy Initiation, for Each Pairwise ComparisonĮTable 7. Baseline Characteristics of Smoking Cessation Pharmacotherapy Initiators in the Comparison of NRT Patch and Bupropion, for Analyses of ACS, Stroke and Cardiovascular DeathĮTable 6. Baseline Characteristics of Smoking Cessation Pharmacotherapy Initiators in the Comparison of Varenicline and NRT Patch, for Analyses of ACS, Stroke and Cardiovascular DeathĮTable 5. Baseline Characteristics of Smoking Cessation Pharmacotherapy Initiators in the Comparison of Varenicline and Bupropion, for Analyses of ACS, Stroke and Cardiovascular DeathĮTable 4. Diagnosis and Procedure Codes Used to Identify Patients With a History of Cardiovascular DiseaseĮTable 3. Identification of the Prespecified Potential ConfoundersĮTable 2.