Evidence map›Paper›PMID 24323793›Full record

ArticleCirculation2014

Cardiovascular events associated with smoking cessation pharmacotherapies: a network meta-analysis.

Edward J Mills, Kristian Thorlund, Shawn Eapen, Ping Wu, Judith J Prochaska

Abstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Nicotine replacement therapy versus control for smoking cessation.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Pooled it
  9. Guideline
  10. Nicotine receptor partial agonists for smoking cessation.The Cochrane database of systematic reviews · 2016
    Pooled it
  11. Pooled it
  12. Pooled it
  13. Trial
  14. Trial
  15. Observational
  16. Review
  17. Article
  18. Review
  19. Review
  20. Observational

32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Edward J MillsStanford Prevention Research Center, Stanford University, Stanford, CA (E.J.M., K.T., J.J.P.); Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada (E.J.M., S.E., P.W.); and Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada (K.T.).
Kristian Thorlund
Shawn Eapen
Ping Wu
Judith J Prochaska

Funding

TREATMENTS FOR COMPLEX PATIENTS IN NEW SETTINGSP50DA009253 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DELUCCHI, KEVIN L. · 1994 to 2014
$28.2M
Evaluation of Tobacco Treatment Strategies for Inpatient PsychiatryR01MH083684 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PROCHASKA, JUDITH J. · 2009 to 2013
$2.6M
Twitter-enabled Mobile Messaging for Smoking Relapse PreventionR34DA030538 · NIDA · UNIVERSITY OF CALIFORNIA-IRVINE · PI PECHMANN, CORNELIA · 2011 to 2013
$659k
CIHRNIDA NIH HHS P50 DA009253NIDA NIH HHS P50 DA09253NIDA NIH HHS R34 DA030538NIMH NIH HHS R01 MH083684
6 · The paper itself

Abstract

backgroundStopping smoking is associated with many important improvements in health and quality of life. The use of cessation medications is recommended to increase the likelihood of quitting. However, there is historical and renewed concern that smoking cessation therapies may increase the risk of cardiovascular disease events associated within the quitting period. We aimed to examine whether the 3 licensed smoking cessation therapies-nicotine replacement therapy, bupropion, and varenicline-were associated with an increased risk of cardiovascular disease events using a network meta-analysis. METHODS AND

resultsWe searched 10 electronic databases, were in communication with authors of published randomized, clinical trials (RCTs), and accessed internal US Food and Drug Administration reports. We included any RCT of the 3 treatments that reported cardiovascular disease outcomes. Among 63 eligible RCTs involving 21 nicotine replacement therapy RCTs, 28 bupropion RCTs, and 18 varenicline RCTs, we found no increase in the risk of all cardiovascular disease events with bupropion (relative risk [RR], 0.98; 95% confidence interval [CI], 0.54-1.73) or varenicline (RR, 1.30; 95% CI, 0.79-2.23). There was an elevated risk associated with nicotine replacement therapy that was driven predominantly by less serious events (RR, 2.29; 95% CI, 1.39-3.82). When we examined major adverse cardiovascular events, we found a protective effect with bupropion (RR, 0.45; 95% CI, 0.21-0.85) and no clear evidence of harm with varenicline (RR, 1.34; 95% CI, 0.66-2.66) or nicotine replacement therapy (RR, 1.95; 95% CI, 0.26-4.30).

conclusionSmoking cessation therapies do not appear to raise the risk of serious cardiovascular disease events.

Indexed as

AdultBenzazepinesBupropionCardiovascular DiseasesDopamine Uptake InhibitorsFemaleHumansMaleNicotineNicotinic AgonistsQuinoxalinesRisk FactorsSmokingSmoking CessationVareniclineBenzazepinesBupropionDopamine Uptake InhibitorsNicotineNicotinic AgonistsQuinoxalinesVareniclinebupropioncardiovascular diseasesmeta-analysissmoking cessationtobacco use cessation productsvarenicline

Identifiers

PMID24323793
PMCPMC4258065

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.