Evidence mapPaperPMID 40035389Full record

ArticleJournal of the American Heart Association2025

Exposure to Lead and Coronary Artery Atherosclerosis: A Swedish Cross-Sectional Population-Based Study.

Erik Rosengren, Lars Barregard, Gerd Sallsten, Björn Fagerberg, Gunnar Engström, Erika Fagman, Niklas Forsgard, Thomas Lundh, Göran Bergström, Florencia Harari

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Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

  1. Review
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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

10 authors.

Erik RosengrenDepartment of Public Health and Community Medicine, Occupational and Environmental Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital Gothenburg Sweden.ORCID 0009-0003-0749-0014
Lars BarregardDepartment of Public Health and Community Medicine, Occupational and Environmental Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital Gothenburg Sweden.ORCID 0000-0002-4662-0841
Gerd SallstenDepartment of Public Health and Community Medicine, Occupational and Environmental Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital Gothenburg Sweden.
Björn FagerbergWallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden.
Gunnar EngströmDepartment of Clinical Sciences in Malmö Lund University Lund Sweden.ORCID 0000-0002-8618-9152
Erika FagmanDepartment of Radiology Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital Gothenburg Sweden.ORCID 0000-0002-0983-0313
Niklas ForsgardRegion Västra Götaland, Sahlgrenska University Hospital Department of Clinical Chemistry Gothenburg Sweden.
Thomas LundhDivision of Occupational and Environmental Medicine, Department of Laboratory Medicine Lund University and Skane University Hospital Lund Sweden.
Göran BergströmWallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden.ORCID 0000-0003-4289-5722
Florencia HarariDepartment of Public Health and Community Medicine, Occupational and Environmental Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital Gothenburg Sweden.ORCID 0000-0002-0362-579X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLead is an established causal risk factor for coronary heart disease. Atherosclerosis may be the key mediator for this association, but evidence from studies in humans is limited. Our objective was to test the hypothesis that environmental lead exposure is associated with coronary atherosclerosis.

methodsWe used cross-sectional data from the SCAPIS (Swedish Cardiopulmonary Bioimage Study), including 5627 men and women aged 50 to 64 years. Coronary artery calcium score (CACS), measured using computed tomography, was used as a marker of atherosclerosis, and blood lead was used as a biomarker of lead exposure. The prevalence ratio (PR) of positive (>0) and high (≥100) CACSs in relation to blood lead (continuous variable) was modeled using Poisson regression with robust SEs, adjusted for age, sex, smoking, low-density lipoprotein/high-density lipoprotein ratio, waist circumference, heredity for cardiovascular diseases, statin use, diabetes, blood cadmium, low physical activity, and educational level.

resultsMedian blood lead was 14.2 μg/L. Positive CACS (prevalence, 41%) was not significantly associated with blood lead (PR per Δ10 μg/L, 1.02 [95% CI, 0.99-1.04]), whereas the association was stronger for high CACS (prevalence, 13%; and PR per Δ10 μg/L, 1.05 [95% CI, 1.00-1.11]). The estimate for high CACS was stronger in men (PR per Δ10 μg/L, 1.07 [95% CI, 1.01-1.13]) than among women (PR per Δ10 μg/L, 1.01 [95% CI, 0.85-1.20]).

conclusionsOur study, which found that lead is associated with coronary artery calcification in men, provides further evidence that lead is a risk factor for atherosclerosis and coronary heart disease.

Indexed as

Coronary Artery DiseaseEnvironmental ExposureLeadBiomarkersCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceRisk AssessmentRisk FactorsSwedenBiomarkersLeadatherosclerosiscoronary artery diseaseenvironmental exposurelead

Identifiers

PMID40035389
PMCPMC12132712

What Socratic holds

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Registered trials

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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 Socratic graph.