Electronic cigarettes and cardiovascular diseases: An updated systematic review and network meta-analysis.

IF 1.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Tobacco Induced Diseases Pub Date : 2025-09-05 eCollection Date: 2025-01-01 DOI:10.18332/tid/208065

Amarit Tansawet, Thunyarat Anothaisintawee, Suparee W Boonmanunt, Prapaporn Pornsuriyasak, Kanokporn Sukhato, Natasha Chawala, Patcharanat Inpithuk, Chatuthanai Savigamin, Saharat Liampeng, John Attia, Gareth J McKay, Ammarin Thakkinstian

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引用次数: 0

Abstract

Introduction: The association between electronic cigarettes (e-cigarettes) and the risk of cardiovascular disease (CVD) remains inconclusive. This study aims to compare CVD risk from the use of e-cigarettes, cigarettes, combined cigarette and e-cigarette use, and non-use.

Methods: This study is a systematic review and network meta-analysis (NMA). MEDLINE and Scopus databases (through February 2024) were used to identify eligible studies. Observational studies that investigated the effect of e-cigarettes on the risk of composite CVD, myocardial infarction (MI), or stroke, compared to cigarette, dual use, or non-use, were included. NMA was applied to estimate relative effects (i.e. adjusted odds ratio, AOR) of e-cigarette, cigarette, and dual use, on composite CVD, MI, and stroke outcomes. Risk of bias was assessed using the Joanna Briggs Institute tool for surveys and the Newcastle-Ottawa scale for cohort studies.

Results: Eleven adult population studies were eligible for review. E-cigarette, cigarette, and dual use were significantly associated with composite CVD outcomes. Pooled AORs (95% CI) were 1.31 (1.05-1.62) for e-cigarette, 1.57 (1.30-1.88) for cigarette, and 1.67 (1.37-2.03) for dual use. Additionally, former cigarette and former dual use significantly increased the risk of composite CVD outcomes, compared to non-use. The pooled AORs (95% CI) were 1.29 (1.05-1.59) for former cigarette, and 1.46 (1.03-2.08) for former dual use, while former e-cigarette use was not significantly associated with composite CVD endpoints. For MI and stroke outcomes, only cigarette and dual use were significantly associated with these events.

Conclusions: Current e-cigarette, cigarette, and dual use were significantly associated with increased risk of composite CVD outcomes, while only cigarette and dual use significantly increased the risk of MI and stroke, compared to non-use. However, these findings were primarily based on cross-sectional data limiting the temporality of effect; additional prospective cohort studies are needed to confirm our findings.

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电子烟与心血管疾病：最新的系统综述和网络荟萃分析。

电子烟（电子烟）与心血管疾病（CVD）风险之间的关联仍然没有定论。这项研究旨在比较使用电子烟、卷烟、香烟和电子烟结合使用以及不使用电子烟的心血管疾病风险。方法：本研究采用系统综述和网络荟萃分析（NMA）。使用MEDLINE和Scopus数据库（截止2024年2月）来确定符合条件的研究。与香烟、双重使用或不使用相比，研究电子烟对复合心血管疾病、心肌梗死（MI）或中风风险影响的观察性研究被纳入其中。应用NMA来估计电子烟、香烟和双重使用对复合心血管疾病、心肌梗死和脑卒中结局的相对影响（即调整优势比AOR）。使用乔安娜布里格斯研究所（Joanna Briggs Institute）的调查工具和纽卡斯尔-渥太华量表（Newcastle-Ottawa scale）进行队列研究，评估偏倚风险。结果：11项成人人群研究符合审查条件。电子烟、香烟和双重使用与复合CVD结果显著相关。电子烟的合并AORs （95% CI）为1.31(1.05-1.62)，卷烟为1.57(1.30-1.88)，两用烟为1.67（1.37-2.03）。此外，与不吸烟相比，以前吸烟和以前双重使用显著增加了复合心血管疾病结果的风险。前吸电子烟者的累积AORs （95% CI）为1.29(1.05-1.59)，前两用者的累积AORs （95% CI）为1.46(1.03-2.08)，而前吸电子烟者与复合心血管疾病终点无显著相关性。对于心肌梗死和中风的结果，只有香烟和双重使用与这些事件显著相关。结论：当前的电子烟、香烟和双重使用与复合心血管疾病结局的风险增加显著相关，而与不使用相比，只有香烟和双重使用显著增加了心肌梗死和中风的风险。然而，这些发现主要是基于限制了影响的时效性的横断面数据；需要更多的前瞻性队列研究来证实我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tobacco Induced Diseases SUBSTANCE ABUSE-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

5.30

自引率

5.40%

发文量

审稿时长

12 weeks

期刊介绍： Tobacco Induced Diseases encompasses all aspects of research related to the prevention and control of tobacco use at a global level. Preventing diseases attributable to tobacco is only one aspect of the journal, whose overall scope is to provide a forum for the publication of research articles that can contribute to reducing the burden of tobacco induced diseases globally. To address this epidemic we believe that there must be an avenue for the publication of research/policy activities on tobacco control initiatives that may be very important at a regional and national level. This approach provides a very important "hands on" service to the tobacco control community at a global scale - as common problems have common solutions. Hence, we see ourselves as "connectors" within this global community. The journal hence encourages the submission of articles from all medical, biological and psychosocial disciplines, ranging from medical and dental clinicians, through health professionals to basic biomedical and clinical scientists.