Muhammad Talal Ashraf^1,3* , Asim Shaikh², Muhammad Khuzzaim Shakeel Khan¹, Naseer Uddin¹, Muhammad Arham bin Kashif¹, Syed Hassan Ahmed Rizvi¹, Hammad Khalid¹, Stafford Jude Sam¹ and Affan Sohail¹

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 metaanalyzed 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

NON-2024-1489