Mariangela Peruzzi, Giuseppe Biondi-Zoccai, Roberto Carnevale, Elena Cavarretta, Giacomo Frati, Francesco Versaci
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引用次数: 19
Abstract
Purpose of review: Modified risk products (MRP) such as electronic vaping cigarettes (EVC) and heat-not-burn cigarettes (HNBC) are alternatives to traditional combustion cigarettes (TCC) with an expanding consumer base. Yet, their cardiovascular health risks are still unclear. We aimed to summarize the evidence base on this topic by conducting an updated umbrella review.
Recent findings: We identified 7 systematic reviews, totaling 183 studies and reports, ranging from in vitro and in animal studies to clinical studies in apparently healthy volunteers and patients at risk of cardiovascular disease. Overall, acute EVC use was associated with several toxic effects at molecular, cellular, tissue, organ, and system level. In addition, EVC impacted adversely on blood pressure (BP) management, caused tachycardia, and worsened arterial stiffness. Finally, EVC use was associated with an increased risk of adverse clinical events, including atrial fibrillation and myocardial infarction, even if the causal link is still debated. Most reviews highlighted that the detrimental impact of EVC was of lesser magnitude of that of TCC. In addition, the differential impact of liquids and nicotine was not clearly disentangled. Finally, no review included studies on HNBC.
Summary: The present umbrella review suggests that EVC, and likely HNBC, despite clearly causing an increase in overall cardiovascular risk, may represent a temporary lesser evil than TCC in a risk-reduction or risk-modification strategy, aiming for eventual abstinence from all tobacco or nicotine products.
期刊介绍：
This journal aims to offer expert review articles on the most significant recent developments in emergency and hospital medicine, with particular emphasis on the transition of patient care from the emergency department to the hospitalist service. By providing clear, insightful, balanced contributions, the journal intends to serve 1) those who provide immediate medical attention to patients with acute injuries or conditions in emergency departments and emergency medical service settings, and 2) hospitalists who deliver comprehensive medical care in collaboration with physicians and other health care personnel responsible for hospitalized patients. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include acute coronary syndrome; chronic obstructive pulmonary disease; community-acquired infections; diabetes and metabolic disease; heart failure; hospital-acquired infections; pharmacology of acute care; shared practice and economic issues; and thrombosis.
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