ArticleBMJ (Clinical research ed.)2012
Use of varenicline for smoking cessation and risk of serious cardiovascular events: nationwide cohort study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Nicotine receptor partial agonists for smoking cessation.The Cochrane database of systematic reviews · 2016Pooled it
- Varenicline and Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2016Pooled it
- A double-blind placebo-controlled randomized trial of varenicline for smokeless tobacco dependence in India.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2014Trial
- Preventive Therapies in Peripheral Arterial Disease.Biomedicines · 2023Review
- Use of Contrave, Naltrexone with Bupropion, Bupropion, or Naltrexone and Major Adverse Cardiovascular Events: A Systematic Literature Review.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Review
- Comparison of Cardiovascular Safety for Smoking Cessation Pharmacotherapies in a Population-Based Cohort in Australia.JAMA network open · 2021Article
- Big Health Data and Cardiovascular Diseases: A Challenge for Research, an Opportunity for Clinical Care.Frontiers in medicine · 2019Review
- Prevention and Treatment of Tobacco Use: JACC Health Promotion Series.Journal of the American College of Cardiology · 2018Review
- New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?CNS drugs · 2016Review
- Effects of varenicline on sympatho-vagal balance and cue reactivity during smoking withdrawal: a randomised placebo-controlled trial.Tobacco induced diseases · 2016Article
- Cardiovascular and neuropsychiatric risks of varenicline: a retrospective cohort study.The Lancet. Respiratory medicine · 2015Article
- Why Don't Smokers Want Help to Quit? A Qualitative Study of Smokers' Attitudes towards Assisted vs. Unassisted Quitting.International journal of environmental research and public health · 2015Article
- Evaluation of the cardiovascular effects of varenicline in rats.Drug design, development and therapy · 2015Article
- Cardiovascular adverse events associated with smoking-cessation pharmacotherapies.Current cardiology reports · 2015Review
- Observational
- Cardiovascular events associated with smoking cessation pharmacotherapies: a network meta-analysis.Circulation · 2014Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether varenicline is associated with an increased risk of serious cardiovascular events compared with another drug used for smoking cessation, bupropion.
designNationwide historical cohort study.
settingDenmark, 2007-10.
participantsNew users of varenicline (n = 17,926) and bupropion (n = 17,926).
main outcome measuresIndividual level data on dispensed drug prescriptions, cardiovascular events, and potential confounders were linked between registries. Cox regression was used to estimate hazard ratios of cardiovascular events in analyses matched for propensity score. The primary outcomes at six months after start of treatment were acute coronary syndrome, ischaemic stroke, and cardiovascular death analysed individually and as a composite of any major event.
resultsThere were 57 major cardiovascular events among varenicline users (6.9 cases per 1000 person years) compared with 60 events among bupropion users (7.1 cases per 1000 person years); the hazard ratio for any major event was 0.96 (95% confidence interval 0.67 to 1.39). Varenicline use was not associated with an increased risk of acute coronary syndrome (1.20, 0.75 to 1.91), ischaemic stroke (0.77, 0.40 to 1.48), and cardiovascular death (0.51, 0.13 to 2.02). In subgroup analyses, the risk of any major cardiovascular event was not significantly different between patients with and without a history of cardiovascular disease (1.24 (0.72 to 2.12) and 0.83 (0.51 to 1.36), respectively; P=0.29).
conclusionsThis cohort study found no increased risk of major cardiovascular events associated with use of varenicline compared with bupropion for smoking cessation. On the basis of the upper confidence limit, the data allowed the exclusion of a 40% increased risk of the composite outcome of any major cardiovascular event. While the estimates were less precise for specific outcomes, any differences would be small in absolute terms.
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