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Novel Methods for Evaluating the Association of Electronic Cigarette Use with Cardiovascular Health

Principal Investigator: Andrew Stokes

Funding Mechanism: National Institutes of Health - Grant

ID number: 1K01HL154130-01

Award Date: 8/1/2020

Institution: Boston University Medical Campus


The goal of this study is to provide population-based evidence on the cardiovascular (CV) effects of e-cigarette use, including particular e-cigarette aerosol components that may be responsible for CV harm. Study aims are: (1) to examine the effects of e-cigarette use and cigarette/e-cigarette transitions on CV events; (2) to estimate associations of e-cigarette use with risk factors and preclinical biomarkers of CV injury, and to analyze biomarkers of exposure as potential mediators; and (3) to identify unique biomarker signatures of e-cigarette exposure and to associate clusters with preclinical biomarkers of CV injury. To achieve Aim 1, the researcher will use data from the Population Assessment of Tobacco and Health (PATH) Study Waves 1-4 (2013-2017) to investigate to what extent e-cigarette use is associated with CV events including myocardial infarction, stroke, and heart failure. To achieve Aim 2, the researcher will assess the effects of e-cigarette use on CV risk factors (blood pressure, triglycerides, and cholesterol) using data from the National Health and Nutrition Examination Survey (NHANES, 2013-2016) and on preclinical biomarkers of CV injury (inflammation, thrombosis, and oxidative stress) using data from PATH Wave 1 (2013-2014). To identify specific e-cigarette aerosol components that mediate CV risk, the researcher will analyze urinary exposure biomarkers for product constituents (nicotine, tobacco-specific nitrosamines [TSNAs], volatile organic compounds [VOCs], polycyclic aromatic hydrocarbons [PAHs], and metals). To achieve Aim 3, the researcher will use data from PATH Wave 1 to define clusters of e-cigarette use based on shared urinary exposure biomarker profiles related to use behaviors (frequency, other tobacco products, and reasons for use) and product characteristics (type and flavors), and associate each with preclinical biomarkers of CV injury. Study findings may inform regulatory activities related to e-cigarettes. 

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