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. 2018 Oct;55(4):455-461.
doi: 10.1016/j.amepre.2018.05.004. Epub 2018 Aug 22.

Association Between Electronic Cigarette Use and Myocardial Infarction

Talal Alzahrani  1 , Ivan Pena  1 , Nardos Temesgen  1 , Stanton A Glantz  2
Affiliations

Association Between Electronic Cigarette Use and Myocardial Infarction

Talal Alzahrani et al. Am J Prev Med. 2018 Oct.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Am J Prev Med. 2019 Oct;57(4):579-584. doi: 10.1016/j.amepre.2019.08.003. Am J Prev Med. 2019. PMID: 31542142 No abstract available.

Abstract

Introduction: Electronic cigarettes (e-cigarettes) are promoted as a less risky alternative to conventional cigarettes and have grown in popularity. Experimental and clinical evidence suggests that they could increase the risk of myocardial infarction.

Methods: The National Health Interview Surveys of 2014 (n=36,697) and 2016 (n=33,028) were used to examine the cross-sectional association between e-cigarette use (never, former, some days, daily) and cigarette smoking (same categories) and myocardial infarction in a single logistic regression model that also included demographics (age, gender, BMI) and health characteristics (hypertension, diabetes, and hypercholesterolemia) using logistic regression. Data were collected in 2014 and 2016 and analyzed in 2017 and 2018.

Results: Daily e-cigarette use was independently associated with increased odds of having had a myocardial infarction (OR=1.79, 95% CI=1.20, 2.66, p=0.004) as was daily conventional cigarette smoking (OR=2.72, 95% CI=2.29, 3.24, p<0.001). Former and some day e-cigarette use were not significantly associated with having had a myocardial infarction (p=0.608 and p=0.392) whereas former (OR=1.70, p<0.001) and some day cigarette smoking (OR=2.36, p<0.001) were. Odds of a myocardial infarction were also increased with history of hypertension (OR=2.32, p<0.001); high cholesterol (OR=2.36, p<0.001); and diabetes (OR=1.77, p<0.001); and age (OR=1.65 per 10 years, p<0.001). Women (OR=0.47, p<0.001) had lower odds of myocardial infarction.

Conclusions: Daily e-cigarette use, adjusted for smoking conventional cigarettes as well as other risk factors, is associated with increased risk of myocardial infarction.

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Figures

Figure 1.
Figure 1.. AORs of e-cigarette and cigarette users.
Notes: Daily e-cigarette use was associated with a statistically significant increase in the odds of having had a myocardial infarction (OR=1.79, 95% CI=1.20, 2.66; p=0.004) controlling for cigarette smoking behavior and demographic and clinical risk factors for myocardial infarction compared to never e-cigarette users who never smoked. By comparison, the odds of having had a myocardial infarction were OR=2.72 (95% CI=2.29, 3.24) for daily cigarette smoking, controlling for e-cigarette use, and the other risk factors.
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