Evidence mapPaperPMID 41204397Full record

SynthesisBMC cardiovascular disorders2025

Toxic heavy metal exposure and heart health: a systematic review and meta-analysis of 324,331 patients.

Shamikha Cheema, Syed Ibad Hussain, Muhammad Shaheer Bin Faheem, Amna Amir Jalal, Mohamed Rifai, Areej Dar, Muhammad Burhan, Areeba Shahid, Muhammad Seerat Ali, Amna Anwar and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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

12 authors.

Shamikha CheemaKing Edward Medical University, Lahore, Pakistan.
Syed Ibad HussainJinnah Sindh Medical University, JSMU, Karachi, Pakistan.
Muhammad Shaheer Bin FaheemDepartment of Medicine and Surgery, Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan.
Amna Amir JalalJinnah Sindh Medical University, JSMU, Karachi, Pakistan.
Mohamed RifaiMenoufia University, Shebin El Kom, Egypt.
Areej DarShaikh Khalifa Bin Zayed Al Nahyan Medical College, Lahore, Pakistan.
Muhammad BurhanDow University of Heath Sciences, Karachi, Pakistan.
Areeba ShahidJinnah Sindh Medical University, JSMU, Karachi, Pakistan.
Muhammad Seerat AliQuaid-E-Azam Medical College, Lahore, Pakistan.
Amna AnwarFederal Medical and Dental College, FMDC, Islamabad, Pakistan.
Misha KhalidKarachi Medical and Dental College, Karachi, Pakistan.
Sumaya SamadiKabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan. dr.sumaya.hs@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHeavy metal pollution is a concerning cardiovascular risk factor and a major public health concern. While traditional cardiovascular disease (CVD) risk factors are well-established, environmental exposures are less recognized, despite their growing significance.

methodsAdhering to PROSPERO and PRISMA guidelines, a search was conducted across PubMed, Cochrane, and Embase until April 2025 for studies involving patients with heart disease or stroke who were exposed to heavy metals. Primary outcomes were the events of CVD, CHD, and stroke. Proportions of events within populations with 95% confidence intervals were pooled. R software was used for the analysis, with statistical significance set at p < 0.05.

resultsWe included 16 studies involving 324,331 participants. The cadmium subgroup showed a pooled proportion of 0.09 (95% CI: 0.01-0.17), with individual values ranging from 0.01 to 0.22; the arsenic subgroup showed a pooled proportion of 0.04 (95% CI: 0.04-0.04). The overall pooled proportion was 0.08 (95% CI: 0.01-0.15). Six studies found cases of CHD in groups exposed to cadmium and arsenic, with combined rates of 0.10 (95% CI: 0.00-0.22) for cadmium and 0.00 (95% CI: 0.00-0.00) for arsenic. The overall pooled proportion was 0.08 (95% CI: 0.00-0.18). Ten studies assessed CVD proportions by metal exposure. Arsenic showed a pooled proportion of 0.06 (95% CI: 0.00-0.18), cadmium 0.14 (95% CI: 0.00-0.31), lead 0.08 (95% CI: 0.01-0.14), and mercury 0.05 (95% CI: 0.04-0.06). The overall pooled proportion was 0.10 (95% CI: 0.03-0.17).

conclusionThis study emphasizes the significance of the toxic environmental metals contributing to cardiovascular risk beyond behavioural risk factors.

Indexed as

Environmental ExposureEnvironmental PollutantsHeart DiseasesMetals, HeavyAdultAgedCardiotoxicityFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedRisk AssessmentRisk FactorsEnvironmental PollutantsMetals, HeavyCardiovascular diseasesHeart HealthMeta-analysisToxic Heavy Metal Exposure

Identifiers

PMID41204397
PMCPMC12595707

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.