Source: International Congress 2014 – Three smoking-related diseases: cardiovascular, lung cancer and infection
Disease area: Airway diseases

Abstract

BackgroundHabitual smoking might elicit a sustained shift in autonomic balance. As a consequence, acute withdrawal might be associated with reverse changes in sympathovagal balance. We hypothesised that these changes are amenable to pharmacological interventions.MethodsIn this randomised controlled trial, smokers (n=36) willing to quit were examined using microneurographic recordings of muscle sympathetic nerve activity (MSNA), baroreflex sensitivity (BRS) and heart rate variability (HRV) before a quit attempt and during acute withdrawal (i.e. three days into their quit attempt). In addition, moderating effects of varenicline and placebo were assessed in a randomised controlled trial.ResultsFor the primary endpoint, changes in MSNA (bursts/100 heart beats) between baseline and withdrawal did not differ significantly between the varenicline and placebo group (-5.29 ± 13.9 vs. -3.02 ± 10.03; p=0.697). Smokers using placebo showed no significant change in MSNA (bursts/100 heart beats) during acute withdrawal as compared to continuing smokers (-3.02 ± 10.03 vs. +0.64 ± 12.62; p=0.516). Results pointed towards a decreased BRS (change by -1.43 ± 6.12 vs. +5.01 ± 7.84 ms/mmHg; p=0.104) during acute withdrawal in the varenicline group as compared to placebo. No relevant differences in HRV were observed between groups.ConclusionCompared with placebo, varenicline did not have significant adverse effects on the autonomic nervous system. This corroborates clinical data suggesting the cardiovascular safety of varenicline.This study was supported by an investigator-initiated grant from Pfizer.

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H. Haarmann, A. Gossler, S. Bonev, S. Andreas, T. Raupach (Goettingen, Mannheim, Immenhausen, Germany). A randomised controlled trial investigating the effects of varenicline on sympathovagal balance during acute nicotine withdrawal. Eur Respir J 2014; 44: Suppl. 58, 322

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