Key result
E-cigarette use was associated with a higher risk of myocardial infarction compared to nonuse (OR 1.291; 95% CI 1.106-1.507; P=0.007), but a lower risk compared to traditional cigarette smoking.
Why the study?
The potential link between e-cigarettes and MI, and whether e-cigarettes pose a lower MI risk compared to tobacco smoking, remains unclear.
Does e-cigarette use increase the risk of myocardial infarction compared to nonuse or traditional cigarette smoking?
Meta-Analysis
Does e-cigarette use increase the risk of myocardial infarction compared to nonuse or traditional cigarette smoking?
E-cigarettes are associated with an increased risk of myocardial infarction compared to nonuse, but may represent a lower-risk alternative to traditional cigarette smoking.
Answers are grounded in this paper and cite their sources.
E-cigarette use was associated with higher MI risk than nonuse but lower than smoking; leaves open causality and need for randomized trials before practice change.
Background: Myocardial infarction (MI) is a global health concern with established risk factors including family history, dyslipidemia, diabetes, and smoking. However, the potential link between e-cigarettes and MI remains unclear. Objectives: This study conducted a meta-meta-analysis to assess the relationship between e-cigarette use and MI and to investigate whether e-cigarettes pose a lower MI risk compared to tobacco smoking. Methods: A literature search on PubMed/MEDLINE and Embase identified meta-analyses on e-cigarette use and MI. Methodological quality was assessed using the AMSTAR 2 framework. Statistical analyses with STATA 18 reported effect sizes as odds ratios (ORs) with 95% confidence intervals, alongside heterogeneity as measured by the I² statistic. A corrected covered area matrix was applied to evaluate publication overlap. Results: Despite limitations and publication overlap, a pooled analysis of three meta-analyses found that e-cigarette users had a higher risk of MI compared to nonusers (OR: 1.291; 95% CI: 1.106–1.507; I 2 = 79.6%; P = 0.007). However, a separate pooled analysis from two meta-analyses showed e-cigarette users had a lower risk of MI compared to traditional cigarette smokers (OR: 0.478; 95% CI: 0.324–0.703; I 2 = 87.8%; P = 0.004). Conclusion: The results highlight the complex risk profile of e-cigarette use. While e-cigarettes are associated with an increased risk of MI compared to nonuse, they may represent a low-risk alternative to traditional cigarette smoking. Further high-quality research is needed to clarify the long-term cardiovascular effects of e-cigarettes and their comparative safety.
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Albert Andrew (2025) conducted a meta-analysis in Myocardial infarction. Electronic cigarette use vs. Nonuse was evaluated on Myocardial infarction (OR 1.291, 95% CI 1.106-1.507, p=0.007). E-cigarette use was associated with a higher risk of myocardial infarction compared to nonuse (OR 1.291; 95% CI 1.106-1.507; P=0.007), but a lower risk compared to traditional cigarette smoking.
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