Coronary Artery Disease, Smoking Cessation
Conditions
Keywords
smoking cessation treatment
Brief summary
It has previously been shown that patients with coronary artery disease may have a harder time quitting smoking if they have a specific genetic profile and that these individuals have a better chance at quitting if they receive nicotine replacement therapy. The investigators hypothesize that determining which individuals with coronary artery disease should receive nicotine replacement therapy based on their genotype may improve the number of individuals who are able to quit smoking.This study randomizes treatment to that determined by the patient's genotype compared to standard, non-genotype-guided, treatment.
Detailed description
In this study, the investigators propose to show the feasibility of incorporating genotype-guided therapy into post-MI smoking cessation therapy and/or smoking cessation therapy in patients with coronary artery disease (CAD) using the CHRNA5 rs16969968 variant as the pilot case. The investigators propose to genotype ½ of PRISM-GENOMICs patients who are active smokers within 48 hours of admission and to guide their smoking cessation therapy based on CHRNA5 rs16969968 genotype (A allele carriers will be given pharmacologic therapy and GG homozygotes will be given counseling). The investigators will use the other ½ as controls. The participants will be followed and the investigators will test whether the genotype-guided group has better rates of smoking cessation compared to the control group. This pilot study will lay the foundation for personalized, genotype-guided, post-MI therapy and/or therapy in patients with CAD.
Interventions
OTHERgenotype-guided therapy
treatment based on patient's CHRNA5 rs16969968 genotype
DRUGNicotine patch
BEHAVIORALSmoking cessation counseling
Sponsors
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Randomized to genotype-guided therapy or standard of care
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult * presenting to Barnes hospital cardiac catheterization laboratory with coronary artery disease or admitted to Barnes hospital within 24 hours of a type 1 myocardial infarction (heart attack) * active smoker at time of presentation to Barnes Hospital * participating in PRISM-GENOMICS observational study
Exclusion criteria
* Unable to provide informed consent * Unable to answer questions (e.g. intubated) * Incarcerated * Complications of myocardial infarction (such as shock, hemodynamic instability, life- threatening infection, etc) * Women of child-bearing age with positive pregnancy test or who is breast feeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Smoking Cessation | 1 month after enrollment | Number of participants no longer smoking as assessed by telephone-administered questionnaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Smoking Cessation | 6 months after enrollment | Number of participants no longer smoking as assessed by telephone-administered questionnaire |
Countries
United States
Outcome results
None listed