ArticleJournal of the American College of Cardiology2024
Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis.
Article in Journal of the American College of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Metallomic Dysregulation and Cardiovascular Disease: Essential Trace Elements, Non-essential Metal Exposure, and Heart Failure Risk: A Systematic Review.Cardiovascular toxicology · 2026Pooled it
- Combined Effects and Potential Mechanisms of Multiple Metals Exposure on Coronary Artery Disease in the US Population: An Integrated Epidemiological and Network Toxicology Study.Biological trace element research · 2026Article
- Association Between Blood Heavy Metals and Selenium with All-Cause Mortality in Cardiovascular-Kidney-Metabolic Syndrome Populations: Exploring the Mediating Effects of Inflammatory Biomarkers.Cardiovascular toxicology · 2026Article
- Metal and metal mixture biomarkers across three U.S. cohorts: MASALA, MESA-LA, and Strong Heart Family Study.Journal of exposure science & environmental epidemiology · 2026Article
- Integrating Environmental Exposure Profiles with Temporal Transcriptomics: An Explainable Machine Learning Model for Cardiovascular Disease Risk Prediction and Biological Validation.Cardiovascular drugs and therapy · 2026Article
- The environmental exposome in heart failure risk and progression.Nature reviews. Cardiology · 2026Review
- Association of cardiovascular risks and carotid stiffening at ultrafast ultrasound imaging in young populations.European radiology · 2026Article
- Cobalt mediates stage-specific toxicity of metal mixtures in cardiovascular-kidney-metabolic syndrome.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- The role of coronary artery calcification in metal-related cardiovascular disease.Environment international · 2026Article
- The mediating role of vascular age in the association between blood metals and atherosclerosis from Manganese-exposed workers healthy cohort.BMC public health · 2026Article
- NDRG1 as a sensor and mediator of endothelial stress: from homeostasis to inflammation and cardiovascular disease.Cellular and molecular life sciences : CMLS · 2025Review
- Associations Between Urinary Metal Levels and Incident Heart Failure: A Multi-Cohort Analysis.JACC. Heart failure · 2025Article
- The Association of Blood Cobalt Levels with Cardiovascular and Chronic Kidney Diseases: Mediating Role of Inflammatory Indicators (SII, NLR, PLR, NMLR, and LMR).Cardiovascular toxicology · 2025Article
- Reply: Urinary Metal Levels and Coronary Artery Calcification: Potential Confounders.Journal of the American College of Cardiology · 2025Article
- NLRP3 inflammasome in cardiovascular diseases: an update.Frontiers in immunology · 2025Review
- Multiple metals exposure and estimated pulse wave velocity: a cross-sectional analysis of the US adults.Frontiers in public health · 2025Article
- Associations of urinary zinc with incident peripheral artery disease and amputation in the Strong Heart Study.Discover endocrinology and metabolism · 2025Article
- Elemental Risk: Role of Metals in Cardiovascular Disease Risk.Journal of the American College of Cardiology · 2024Article
- Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA).Circulation · 2024Article
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18 authors.
Funding
Abstract
backgroundExposure to metals, a newly recognized risk factor for cardiovascular disease (CVD), could be related to atherosclerosis progression.
objectivesThe authors hypothesized that higher urinary levels of nonessential (cadmium, tungsten, uranium) and essential (cobalt, copper, zinc) metals previously associated with CVD would be associated with baseline and rate of change of coronary artery calcium (CAC) progression, a subclinical marker of CVD in MESA (Multi-Ethnic Study of Atherosclerosis).
methodsWe analyzed data from 6,418 MESA participants with spot urinary metal levels at baseline (2000-2002) and 1 to 4 repeated, continuous measures of CAC over a 10-year period. We used linear mixed-effect models to assess the association of baseline urinary metal levels with baseline CAC and cumulative change in CAC over a 10-year period. Urinary metals (μg/g creatinine) and CAC were log transformed. Models were adjusted for baseline sociodemographic factors, estimated glomerular filtration rate, lifestyle factors, and clinical factors.
resultsAt baseline, the median CAC was 6.3 (Q1-Q3: 0.7-58.2). Comparing the highest to lowest quartile of urinary cadmium, CAC levels were 51% (95% CI: 32%, 74%) higher at baseline and 75% (95% CI: 47%, 107%) higher over the 10-year period. For urinary tungsten, uranium, and cobalt, the corresponding CAC levels over the 10-year period were 45% (95% CI: 23%, 71%), 39% (95% CI: 17%, 64%), and 47% (95% CI: 25%, 74%) higher, respectively, with no difference for models with and without adjustment for clinical factors. For copper and zinc, the corresponding estimates dropped from 55% to 33% and from 85% to 57%, respectively, after adjustment for clinical factors. The associations of metals with CAC were comparable in magnitude to those for classical CVD risk factors.
conclusionsExposure to metals was generally associated with extent of coronary calcification at baseline and follow-up. These findings support that metals are associated with the progression of atherosclerosis, potentially providing a novel strategy for the prevention and treatment of atherosclerosis progression.
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