No evidence from human studies has demonstrated that NRT increases the risk of healing-related or cardiovascular complications in the perioperative period. Nolan MB, Warner DO. Safety and Efficacy of Nicotine Replacement Therapy in the Perioperative Period: A Narrative Review. Mayo Clin Proc. 2015 Nov;90(11):1553-61.
Patients with cardiovascular disease who continue to smoke have an increased risk of myocardial infarction, cerebrovascular accident, and other serious vascular events. Studies have indicated no increase in cardiovascular events in those who use NRT compared with those who continue to smoke. Ford CL, Zlabek JA. Nicotine replacement therapy and cardiovascular disease. Mayo Clin Proc. 2005 May;80(5):652-6.
High-dose nicotine treatment, even with concomitant smoking, caused no short-term adverse effects on the cardiovascular system.Zevin S, Jacob P III, Benowitz NL. Dose-related cardiovascular and endocrine effects of transdermal nicotine. Clin Pharmacol Ther. 1998 Jul;64(1):87-95.
Nicotine delivered by transdermal system is free of cardiac adverse effects in healthy volunteers. Khoury Z, Comans P, Keren A, Lerer T, Gavish A, Tzivoni D. Effects of transdermal nicotine patches on ambulatory ECG monitoring findings: a double-blind study in healthy smokers. Cardiovasc Drugs Ther. 1996 May;10(2):179-84.
Transdermal nicotine does not cause a significant increase in cardiovascular events in high-risk outpatients with cardiac disease. Joseph AM, Norman SM, Ferry LH, Prochazka AV, Westman EC, Steele BG, Sherman SE, Cleveland M, Antonnucio DO, Hartman N, McGovern PG: The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 1996; 335:1792–8