NEW ORLEANS (Reuters Health) - Patients with coronary artery disease (CAD) and stress-induced ischemia can safely use nicotine patches in their efforts to stop smoking, Houston cardiologists told their colleagues here this week at the 56th annual scientific session of the American College of Cardiology.

Dr. Monika J. Leja of The Methodist DeBakey Heart Center in Houston presented findings of a randomized, placebo-controlled trial of nicotine patches in 55 patients with CAD.

All patients smoked approximately 29 cigarettes a day and had a 9% or greater stress-induced myocardial perfusion defect, according to single-photon tomography (SPECT).

Patients were randomized to nicotine patches containing 21 mg nicotine or a placebo patch. Exhaled carbon monoxide levels and plasma levels of nicotine were measured before each SPECT. The primary endpoint was change in size of perfusion defect.

SPECT was repeated after 1 week. Patients were then counseled to stop smoking and SPECT was again repeated 4 weeks after they began to use the patches.

By 4 weeks, many patients using the nicotine patch were able to stop smoking. The overall average tobacco use was about 8 cigarettes a day compared with around 11 cigarettes a day in those on placebo. There was a corresponding decrease in exhaled carbon monoxide levels.

"Plasma levels of nicotine in active patch users were double the levels found in the control group," Dr. Leja reported. Despite this, there was no change is perfusion defect size.

The findings "are consistent with the safety of nicotine patches in patient with coronary artery disease and stress-induced ischemia," she said.

A larger trial studying cardiac events is necessary to confirm these findings, Dr. Leja noted.