Evidence map›Paper›PMID 41382044›Full record

SynthesisBMC public health2025

Are electronic cigarettes associated with the risk of myocardial infarction and stroke? A systematic review and meta-analysis.

Ruchika Gupta, Prashant Kumar Singh, Sagarika Rout, Lorena C Mariano, Chander Prakash Yadav, Shalini Singh

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ruchika Gupta *Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
Prashant Kumar Singh *Division of Preventive Oncology and Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
Sagarika RoutDivision of Preventive Oncology and Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
Lorena C MarianoUNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal.
Chander Prakash YadavICMR-National Institute of Cancer Prevention and Research, Noida, India.
Shalini SinghWHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, India. shalinisingh.icmr@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe existing studies in the literature have provided conflicting results on the association of e-cigarettes with myocardial infarction (MI) and stroke. Hence, the present systematic review and meta-analysis (SRMA) aimed at critically reviewing and summarizing the currently available evidence of the association of e-cigarettes with MI and stroke.

methodsThe protocol was registered with PROSPERO (CRD42023467397). A systematic search of databases including PubMed, Cochrane database, and Web of Science was conducted between January 2005 through June 2025 for observational studies and randomized trials evaluating the association of e-cigarettes with MI and stroke. The included studies were reviewed critically for appropriateness and absence of conflict of interest of the authors with regard to the topic of analysis. Quantitative synthesis was performed using a random effect model for summary estimate (meta-odds ratio, meta-OR) of MI and stroke in e-cigarette users.

resultsWe included 12 studies providing a total of 26 estimates - 11 for MI (67,253 e-cigarette users and 363,622 non-users) and 15 for stroke (121,113 e-cigarette users and 1,064,228 non-users). Quantitative synthesis showed that e-cigarette users had a 1.53-times higher risk of MI than the non-e-cigarette users (95% CI 1.17-1.89). Adjusting for cigarette smoking as a confounder yielded similar results (meta-OR 1.24, 95% CI 1.11-1.37). The risk of MI was higher among current e-cigarette users who were former cigarette smokers than never-e-cigarette users (meta-OR 2.52, 95% CI 1.88-3.16). Similarly, stroke was found to be 1.05 times more frequent among e-cigarette users than non-users (95% CI 0.91-1.19). Restriction to studies adjusting for cigarette smoking as a confounder did not affect the results. The risk of stroke was 1.73 times higher among e-cigarette users who were former conventional cigarette smokers (95% CI 1.30-2.15) compared to non-e-cigarette users.

conclusionsThe use of e-cigarettes may be linked with a higher risk of myocardial infarction as well as stroke, even after adjusting for cigarette smoking as a confounder or in those who were former conventional cigarette smokers. Further well-designed longitudinal studies are needed to confirm these findings and inform policymakers on the health effects of e-cigarette use.

Indexed as

Electronic Nicotine Delivery SystemsMyocardial InfarctionStrokeHumansRisk FactorsCardiovascularE-cigarettesElectronic cigarettesMeta-analysisMyocardial infarctionStroke

Identifiers

PMID41382044
PMCPMC12801771

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.