2026-04-29T23:04:21Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/254912025-12-18T12:56:52Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608

00925njm 22002777a 4500 dc McGraw, Katlyn E author Schilling, Kathrin author Glabonjat, Ronald A author Galvez-Fernandez, Marta author Domingo-Relloso, Arce author Martinez-Morata, Irene author Jones, Miranda R author Nigra, Anne author Post, Wendy S author Kaufman, Joel author Tellez-Plaza, Maria author Valeri, Linda author Brown, Elizabeth R author Kronmal, Richard A author Barr, R Graham author Shea, Steven author Navas-Acien, Ana author Sanchez, Tiffany R author 2024-10-15 Background: Exposure to metals, a newly recognized risk factor for cardiovascular disease (CVD), could be related to atherosclerosis progression. Objectives: The 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). Methods: We 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. Results: At 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. Conclusions: Exposure 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. J Am Coll Cardiol. 2024 Oct 15;84(16):1545-1557. 10.1016/j.jacc.2024.07.020 1558-3597 0735-1097 Journal of the American College of Cardiology 39297845 https://hdl.handle.net/20.500.12105/25491 Cadmium Cardiovascular disease Cobalt Copper Coronary artery calcification Longitudinal Metals Mixed models Prospective Tungsten Uranium Zinc Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis