ArticleCureus2025
Serum Heavy Metal Burden and Its Association With Angiographic Severity and Six-Month Outcomes in Coronary Artery Disease: A Prospective Observational Study From North India.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeavy metal exposure is a silent yet significant cardiovascular risk factor, particularly in low- and middle-income countries with evolving environmental and dietary patterns. Metals like cadmium, arsenic, and mercury contribute to atherogenesis through oxidative stress, inflammation, and endothelial dysfunction. However, their association with coronary artery disease (CAD) severity and clinical outcomes remains underexplored in Indian populations. This study evaluated serum levels of six heavy metals and their relation to angiographic complexity and six-month cardiovascular outcomes.
methodsIn this single-center, prospective study, 497 patients undergoing coronary angiography for CAD were enrolled and stratified by the SYNTAX score: SYNTAX score <23 and SYNTAX score ≥23. Serum levels of arsenic, antimony, mercury, lead, nickel, and cadmium were quantified using inductively coupled plasma mass spectrometry (ICP-MS). SYNTAX score, clinical parameters, and six-month outcomes for major adverse cardiovascular events (MACE) were recorded.
resultsMean SYNTAX scores did not differ significantly across quartiles of any heavy metal (all p > 0.05). Adjusted analysis showed no association between metal levels and high SYNTAX score (adjusted OR = 1.07, 95% CI 0.89-1.30, for cadmium per SD increase). However, subgroup analysis revealed higher cadmium levels in patients with acute coronary syndrome (ACS) compared to stable CAD patients (median = 0.78 (IQR 0.65-0.94) µg/L vs. 0.62 (IQR 0.54-0.75) µg/L; p = 0.006), and elevated arsenic and mercury levels in hypertensive patients (mean difference = +1.21 µg/L (95% CI 0.58-1.84), p = 0.001; +0.34 µg/L (95% CI 0.15-0.53), p = 0.0013). At the six-month follow-up, MACE occurred in 6.6% of patients and were associated with a high SYNTAX score (OR = 4.4 (95% CI 1.7-11.5), p = 0.002), but not with any metal level (all p > 0.1).
conclusionSerum heavy metal levels were not associated with angiographic CAD severity. Nevertheless, higher cadmium levels in ACS patients and elevated arsenic/mercury levels in hypertensive patients suggest that metal exposure may influence disease phenotype rather than plaque burden. These exploratory findings warrant validation in larger longitudinal cohorts.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.