Association between e-cigarette use and myocardial infarction: a systematic review and meta-analysis

Abstract

Background: The popularity of e-cigarettes has risen dramatically over the last few years, particularly among the younger population. Although the use of combustible cigarettes has established evidence to be associated with the development of several adverse cardiopulmonary diseases, the investigations regarding the prospective long-term effects of e-cigarette use on the cardiovascular system have just begun. We set to investigate if there is an association between the history of MI and e-cigarette use among smokers and non-smokers?

Methods: The current review aims to assess the association of myocardial infarction with e-cigarette consumption. PubMed, Google Scholar, and Cochrane Central Register of Controlled Trials (CENTRAL) were queried up to October 2022 to identify articles assessing the incidence of myocardial infarction among e-cigarette users. Data were meta-analyzed using a random-effects model to derive odds ratios (OR) and 95% confidence intervals.

Results: Nine studies involving 984,764 patients were included. The mean age of e-cigarette smokers was less than the controls, and female participants dominated the sample size. E-cigarette users were associated with increased odds of MI than non-users [OR = 1.44; 95% CI (1.22, 1.74); P < 0.0001]. Dual users were also associated with increased odds of MI with large effect when compared to non-users [OR = 4.04; 95% CI (3.40, 4.81); P < 0.00001].

Conclusions: Dual use is associated with an increased risk of MI than e-cigarette use only. Similarly, dual and solely e-cigarette consumption patterns of nicotine delivery are at a higher risk of MI than non-smokers.

Keywords: Cardiology; Cardiovascular; Electronic cigarettes; Myocardial infarction; Myocardial ischemia; Vape.

Fig. 1

PRISMA flowchart

Fig. 2

E-cigarette users vs non-users

Fig. 3

Dual users vs non-users

Fig. 4

E-cigarettes everyday vs non-users

Fig. 5

E-cigarettes Somedays vs non-users

Fig. 6

E-cigarettes former vs non-users

Fig. 7

E-cigarettes anytime users vs never users