E-Cigarette Use and Risk of Cardiovascular Disease: a Longitudinal analysis of the PaTh Study (2013-2019).

Introduction:
This text is a summary of a longitudinal study on the association between e-cigarette use and the risk of cardiovascular disease (CVD) using data from the Population assessment of Tobacco and health (PaTh) Study. The study aims to contribute to the understanding of the long-term health effects of e-cigarette use.

Key Points:

* The study included 24,027 eligible respondents and followed them for up to four years.
* The study defined incident CVD as any self-reported past 12-month diagnosis of myocardial infarction (MI), bypass surgery, heart failure (hF), other heart condition, or stroke over Waves 2-5.
* The study found that participants exclusively using e-cigarettes had a similar risk of developing any CVD condition compared with nonusers (hR, 1.00; 95% CI, 0.69--1.45).
* Compared with smoking, e-cigarette use was associated with 30-40% lower CVD risk, although this association was only significant for the any CVD outcome.
* Dual users had a similar risk of CVD compared with exclusive smokers for the any CVD and MI, hF, or stroke outcomes.
* The study was limited by a small number of CVD events in e-cigarette users, self-reported, non-adjudicated outcomes, and a short follow-up period.
* The study suggests that combining smoking with e-cigarette use does not reduce CVD events and that quitting both products is required to ensure a mitigation of risk.

Main Message:
The study provides valuable insights into the long-term health effects of e-cigarette use and suggests that exclusive e-cigarette use is not associated with a significant increase in the risk of CVD compared with nonuse. however, dual use of cigarettes and e-cigarettes was associated with a significantly increased risk of CVD compared with nonuse, and the cardiovascular risk of dual use did not differ from the risk among those exclusively smoking cigarettes. Therefore, the study emphasizes the importance of quitting both products to mitigate the risk of CVD. additionally, the study highlights the need for larger and longer studies with more cardiovascular outcome events to further investigate the association between e-cigarette use and CVD.

Berlowitz JB, Xie W, harlow aF, et al. E-Cigarette Use and Risk of Cardiovascular Disease: a Longitudinal analysis of the PaTh Study (2013-2019). Circulation. 2022;145(20):1557-1559. doi:10.1161/CIRCULaTIONaha.121.057369