| Objective:This study investigated the effects of varenicline on the success rate of smoking cessation,tobacco withdrawal symptoms,adverse cardiovascular events,anxiety and depressive symptoms,and state of mind in patients with tobacco dependence after coronary heart disease intervention.And it also to evaluate the effectiveness and safety of varenicline for smoking cessationin patients with tobacco dependenceafter coronary heart diseaseintervention.Methods:In this prospective cohort study,80 patients who were admitted to the Department of Cardiology of the First Affiliated Hospital of Gannan Medical College from December 2021 to June 2022 and met the inclusion and exclusion criteria of this study were selected for the study.80 patients who underwent percutaneous coronary intervention(PCI)with tobacco dependence were numbered according to the order of enrollment,and the even-numbered patients were enrolled inthe experimental group(varenicline treatmentgroup)andtheodd-numbered patients were enrolled in the control group(conventional treatment group),40 cases each.All patients were given treatment related to secondary prevention of coronary heart disease,such as anti-platelet aggregation,lipid regulation and plaque stabilization,ventricular rate control,inhibition of myocardial remodeling,blood pressure and blood sugar control,and education on smoking cessation,according to their conditions.The control group(conventional treatment group)was given the telephone intervention of smoking cessation on the basis of conventional treatment for secondary prevention of coronary heart disease,and the experimental group(varenicline treatment group)was given the drug varenicline on the basis of conventional treatment group.The experimental group and the control group were routinely followed up six times for six months,at the first week,second week,third week,first month,third month,and sixth month of smoking cessation,respectively,to observe patients’ smoking cessation-related conditions(success rate of smoking cessation,occurrence of tobacco withdrawal symptoms),as well as the changes in the scores of the Patient Health Questonnaire-9(PHQ-9),Generalized Anxiety Disorder(GAD-7)and Profile of Mood States(PMOS).It also observes patients for the occurrence of adverse cardiovascular events: angina pectoris,heart failure,myocardial infarction,malignant arrhythmias,etc.This study used chi-square test,t-test,repeated measures ANOVA,and binary logistic one-way regression analysis to assess the effectiveness and safety of varenicline on smoking cessation in patients with tobacco dependence after coronary heart diseaseintervention.Results:In this study,80 patients(all men)were enrolled,and after 6 months of smoking cessation intervention,no patients were lost in the conventional treatment group,and a total of 40 patients were lost.In the varenicline treatment group,3 patients stopped using varenicline and withdrew from this study on their own,and a total of 37 patients completed the follow-up.Finally,a total of77 peoplecompleted this clinical trial.Before giving the smoking cessation intervention,there were no statistically significant differences in the general conditions(age,duration of smoking,daily smoking,FTND score,lesions of coronary arteries and comorbid diseases)between the two groups(P>0.05);the differences in the PHQ-9,POMS,and GAD-7 scale scores between the two groups before the intervention werenot statistically significant(P>0.05),and this study was comparable.1、In the Comparison of the success rate of smoking cessation between the two groups:26 patients in the varenicline treatment group succeeded in quitting smoking,with a success rate of 70.3%,and 16 patients in the conventional treatment group succeeded in quitting smoking,with a success rate of 40.0%.The success rate of smoking cessation in the varenicline treatment group was significantly higher than that in the conventional treatment group,and the differencebetween the two groups was statistically significant(P<0.05).2、In the comparison of the incidence of withdrawal symptoms between the two groups:The incidence of smoking craving in the varenicline treatment group was 37.8%,the incidence of inability to concentrate was 16.2%,the incidence of irritability was 24.3%,the incidence of gastrointestinal reactions was 13.5%,and the incidence of insomnia was 5.4%.The incidence of smoking craving in the conventional treatment group was 65.0%,the incidence of inability to concentrate was 37.5%,the incidence of irritability was 50.0%,the incidence of gastrointestinal reactions was 27.5%,and the incidence of insomnia was 12.5%.The incidence of withdrawal symptoms such as smoking craving,inability to concentrate,and irritability was significantly lower in the varenicline treatment group than in the conventional treatment group,and the difference between the two groups was statistically significant(P<0.05).In the presence of withdrawal symptoms such as gastrointestinal reactions and insomnia,the varenicline treatment group was lower than the conventional treatment group,but the difference between thetwo groups,was not statistically significant(P>0.05).3、In the comparison of the incidence of adverse cardiovascular events in the two groups:Two people in the varenicline treatment group had angina pectoris and no other adverse cardiovascular events,and their rate of adverse cardiovascular events was 5.4%;five people in the conventional treatment group had angina pectoris and again no other adverse cardiovascular events,and their rate of adverse cardiovascular events was 12.5%.The incidence of adverse cardiovascular events was lower in the varenicline treatment group than in the conventional treatment group,but the difference between the two groups,however,was not statistically significant(P>0.05).4、In the comparison of GAD-7,PHQ-9,and PMOS scale scores at different time points between the two groups:The GAD-7,PHQ-9,and PMOS scale scores were significantly lower in the varenicline treatment group at the first week,second week,third week,first month,third month,and sixth month follow-ups after the intervention than before the intervention,with statistically significant differences(P<0.05).In the conventional treatment group,the GAD-7,PHQ-9,and PMOS scale scores were lower than those before the intervention at the first week after the intervention,but the differences were not statistically significant(P>0.05);at the second week,third week,first month,third month,and sixth month follow-ups,the GAD-7,PHQ-9,and PMOS scale scores were lower than those before the intervention,and the differences were statistically significant(P<0.05).In the comparison between the two groups after the intervention,the scores on the GAD-7,PHQ-9,and PMOS scales were lower in the varenicline treatment group than in the conventional treatment group during the six follow-up visits,and the difference between thetwogroups,was statistically significant(P<0.05).5、Binary logistic univariate regression analysis found that varenicline was associated with smoking cessation success(OR=3.545 B=1.266 P=0.009),suggesting that varenicline can improve the success rate of smoking cessation in patients with tobacco dependence after coronary heartdisease intervention,whichis statistically significant.Conclusion:In patients with tobacco dependence coronary heart disease intervention,varenicline can significantly improve the success rate of smoking cessation and reduce the occurrence of withdrawal symptoms,as well as improve the patients’ state of mind and reduce the occurrence of anxiety,depression and other adverse emotions.Patients in the varenicline group had a lower probability of adverse cardiovascular events after coronary heart disease intervention.The safety and efficacy of varenicline are worthy of affirmation and can be further promoted and applied inclinical treatment. |
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