Bupropion, smoking cessation, and health-related quality of life following an acute myocardial infarction

J Popul Ther Clin Pharmacol. 2014;21(3):e346-56. Epub 2014 Oct 8.

Abstract

Background: The use of bupropion, a smoking cessation aid, has been associated with improved health-related quality of life (HRQOL) in the general population of smokers; but, its effect on HRQOL in post-myocardial infarction (MI) patients remains unknown.

Objectives: To examine the effect of bupropion on HRQOL in post-MI patients who are attempting to quit smoking.

Methods: To accomplish this objective, we used data from a randomized, double-blind, placebo-controlled trial in 392 hospitalized post-MI patients. Treatment duration was 9 weeks, and follow-up was 12 months. HRQOL was assessed via the EuroQol-5D (EQ-5D) questionnaire, which includes 5 dimensions (mobility, self-care, daily activities, pain/discomfort, and anxiety/depression). Analyses were restricted to patients (n=225) who completed the EQ-5D at baseline, 6 months, and 12 months.

Results: Patients randomized to bupropion (n=109) and those randomized to placebo (n=116) experienced similar improvements in HRQOL during follow-up (difference in change in EQ-5D index from baseline to 6 months = 0.02, 95% confidence interval [CI] = -0.04, 0.08; from baseline to 12 months = 0.02, 95% CI = -0.04, 0.08). No between-group differences were observed in any of the 5 dimensions. Similar improvements in HRQOL were observed between patients who remained abstinent and those who relapsed. Lower baseline HRQOL, defined as having a HRQOL that was less than the median value, was associated with decreased smoking abstinence at 12 months follow-up (odds ratio OR =0.39, 95% CI = 0.22, 0.68).

Conclusions: Bupropion does not improve HRQOL among patients attempting to quit smoking post-MI.

Trial registration: ClinicalTrials.gov NCT00689611.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bupropion / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Odds Ratio
  • Prevalence
  • Quality of Life*
  • Quebec / epidemiology
  • Risk Factors
  • Risk Reduction Behavior*
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / psychology
  • Smoking Cessation / methods*
  • Smoking Prevention*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome

Substances

  • Bupropion

Associated data

  • ClinicalTrials.gov/NCT00689611