Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Nicotine Replacement Therapy in Smokers with CHD

J Am Heart Assoc; ePub 2018 Sep 7; Pack, et al

The use of nicotine replacement therapy (NRT) was not associated with any differences in short-term outcomes among smokers hospitalized for treatment of coronary heart disease (CHD), a recent study found. Researchers examined the short-term safety of NRT in a geographically and structurally diverse sample of US hospitals in 2014. They compared smokers who started NRT in the first 2 days of hospitalization with smokers without any exposure to NRT. Outcomes included inpatient mortality, hospital length of stay (LOS), and 1-month readmission. Among the findings:

  • From 270 hospitals, 27,459 smokers (mean age 58 years, 69% men, 56.9% in ICU) were included, of whom 4,885 (17.8%) received NRT.
  • Among patients with myocardial infarction, those who received NRT showed no difference in mortality, mean LOS, or 1-month readmission, when compared with patients who did not receive NRT.
  • Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery.
  • NRT is a safe and reasonable treatment option in treating nicotine withdrawal.


Pack QR, Priya A, Lagu TC, et al. Short-term safety of nicotine replacement in smokers hospitalized with coronary heart disease. [Published online ahead of print September 7, 2018]. J Am Heart Assoc. doi:10.1161/JAHA.118.009424.