# Secondary Prevention Following Acute Coronary Syndrome Using Integrated Smoking Cessation and Mood Management

> **NIH NIH R01** · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · 2021 · $619,859

## Abstract

Project Summary/Abstract
 Approximately 400,000 smokers survive an Acute Coronary Syndrome (ACS; unstable angina, ST and
non-ST elevation myocardial infarction) each year in the US. The occurrence of ACS can be conceptualized as
a “teachable moment,” whereby patients may be more receptive to smoking cessation messages. Continued
smoking following ACS is an independent predictor of mortality. Depressed mood post-ACS is also predictive
of mortality, and smokers with depressed mood are less likely to abstain from smoking following an ACS
hospitalization. Thus, a single, integrated treatment that targets both depressed mood and smoking could be
highly effective in reducing post-ACS mortality. Behavioral Activation may be an ideal counseling treatment for
this population because it is easy to train, can be delivered by Bachelor's degree level practitioners, and has
recently shown promise for enhancing cessation outcomes in smokers with depression. Through extensive
pilot work we systematically developed a counseling intervention that integrates gold standard smoking
cessation counseling with Behavioral Activation based mood management for post-ACS smokers; Behavioral
Activation Treatment for Cardiac Smokers (BAT-CS). The overall aim of the current study is to conduct a fully
powered efficacy trial enrolling 324 smokers with ACS and randomizing them to 12 weeks of BAT-CS or
control (including full attention match). Both groups will be offered the nicotine patch if medically cleared.
Follow-up assessments will be conducted at end-of-treatment and 6, 9, and 12 months after hospital
discharge. We will track the occurrence of major adverse cardiac events and all-cause mortality for 18-36
months post-discharge. The primary outcomes will be depressed mood and biochemically validated 7-day
point prevalence abstinence. The specific aims of the study are: Aim I: Test the efficacy of BAT-CS vs. control
on depressed mood and smoking cessation. Aim II: Test the efficacy of BAT-CS vs. control on cardiac health.
Aim III: Explore hypothesized mediators of treatment effects. Aim IV: Explore the temporal interaction of
smoking and multiple aspects of mood over 1 year post-ACS. The long-term goal of this line of research is to
improve long-term survival rates following ACS.

## Key facts

- **NIH application ID:** 9994997
- **Project number:** 5R01HL136327-04
- **Recipient organization:** HENNEPIN HEALTHCARE RESEARCH INSTITUTE
- **Principal Investigator:** Andrew M Busch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $619,859
- **Award type:** 5
- **Project period:** 2017-08-18 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994997

## Citation

> US National Institutes of Health, RePORTER application 9994997, Secondary Prevention Following Acute Coronary Syndrome Using Integrated Smoking Cessation and Mood Management (5R01HL136327-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9994997. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*