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Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death

Hubbard, R.; Lewis, S.; Smith, C.; Godfrey, C.; Smeeth, L.; Farrington, P. and Britton, J. (2005). Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death. Tobacco Control, 14(6) pp. 416–421.

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Objective: To determine whether nicotine replacement therapy (NRT) is associated with an increased risk of acute myocardial infarction, acute stroke, or death. Design: Self control case series analysis of data from The Health Improvement Network (THIN) to estimate the relative incidence of myocardial infarction and stroke in four 14 day periods before and after the first prescription for NRT. Setting: THIN is a computerised general practice database. Subjects: Patients contributing data to THIN. Interventions: Observational study of NRT. Main outcomes: Acute myocardial infarction, acute stroke, and death. Results: 33 247 individuals had been prescribed NRT, of whom 861 had had a myocardial infarction and 506 a stroke. There was a progressive increase in the incidence of first myocardial infarction in the 56 days leading up to the first NRT prescription (overall incidence ratio 5.55, 95% confidence interval (Cl) 4.42 to 6.98), but the incidence fell after this time and was not increased in the 56 days after starting NRT (incidence ratio 1.27, 95% Cl 0.82 to 1.97). The results were similar for second myocardial infarction and stroke, and for subgroups of people with pre-existing angina and hypertension. There were 960 deaths in our cohort during a mean follow up period of 2.6 years after starting NRT, with no evidence of an increased mortality in the 56 days after the NRT prescription (incidence ratio 0.86, 95% Cl 0.60 to 1.23). Conclusions: The use of NRT is not associated with any increase in the risk of myocardial infarction, stroke, or death.

Item Type: Journal Item
Copyright Holders: 2005 BMJ Publishing Group Ltd.
ISSN: 0964-4563
Project Funding Details:
Funded Project NameProject IDFunding Body
Not SetNot SetBritish Lung Foundation
Not SetNot SetWellcome Trust
Academic Unit/School: Faculty of Science, Technology, Engineering and Mathematics (STEM) > Mathematics and Statistics
Faculty of Science, Technology, Engineering and Mathematics (STEM)
Item ID: 18154
Depositing User: Colin Smith
Date Deposited: 07 Sep 2009 10:46
Last Modified: 01 May 2019 13:23
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