Another study links e-cigs to heart attacks, this time using the FDA/NIH PATH dataset

Dharma Bhatta and I presented this abstract at the 2019 Society for Research on Nicotine and Tobacco meeting.  It shows about the same risks as the earlier studies.  This is also exactly what one would expect to happen based on the biological effects that e-cigs have on blood vessels and platelets.

POS4-99

ELECTRONIC CIGARETTE USE AND MYOCARDIAL INFARCTION AMONG ADULTS IN THE UNITED STATES POPULATION ASSESSMENT OF TOBACCO AND HEALTH

Dharma N. Bhatta, PhD, MPH, Stanton Glantz, PhD. University of California San Francisco, San Francisco, CA, USA.

Background: Electronic cigarettes are battery operated nicotine delivery devices, popular for smoking cessation tools and as an alternative product to combustible cigarettes. This study aim is to determine the association between electronic cigarette use and myocardial infarction.

Methods: Adults age 18 and older at Wave 1 (n = 32,320; 2013-2014) and Wave 2 (n=26,447; 2014-2015) of the Population Assessment of Tobacco and Health (PATH) study in the United States of America were used. Multivariable logistic regression was performed to determine the associations between e-cigarette use and myocardial infarction, adjusting for cigarette smoking, demographic and clinical variables.

Results: Every day (adjusted odds ratio 2.29, 95% CI: 1.25, 4.22) and some day (1.91, 95% CI: 1.08, 3.38) e-cigarette use were independently associated with increased odds of having had a myocardial infarction with a significant dose-response (P < 0.0005), controlling for conventional cigarette smoking and demographic and clinical risk factors in a cross-sectional analysis of Wave 1. Odds of having had a myocardial infarction among current dual user is 6.64 compared with a never smoker who never used e-cig-arettes. Having had a myocardial infarction at Wave 1 did not predict e-cigarette use at Wave 2 (p>0.62), suggesting that reverse causality cannot explain the cross-sectional association between e-cigarette use and myocardial infarction observed at Wave 1.

Conclusions: Some day and every day e-cigarette use are associated with increased risk of having had a myocardial infarction, in addition to the effect of any combustible cigarette smoking. Dual use is riskier than using either product alone.