Environmental toxic metal contaminants and risk of cardiovascular disease

Title Environmental toxic metal contaminants and risk of cardiovascular disease
Journal British Medical Journal
Authors Chowdhury R, Ramond A, O’Keeffe LM, et al.
Year Published 2018
Link to article

Conclusion
Exposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioral risk factors.

Cadmium level and severity of peripheral artery disease in patients with coronary artery disease

Title Cadmium level and severity of peripheral artery disease in patients with coronary artery disease
Journal European Journal of Preventive Cardiology
Authors Ujueta F, Arenas IA, Diaz D, et al.
Year Published 2018
Link to article

Abstract
Coronary artery disease (CAD) and peripheral artery disease (PAD) both share similar risk factor profiles, representing a high disease burden and cost worldwide. Yet the preferential development of CAD, PAD, or both in individual patients is not fully understood. As part of a study of toxic metals in patients with vascular disease, we explored toxic metal profiles in three principal diagnoses: CAD, PAD, and PAD with critical limb ischemia (CLI). CLI is the most advanced form of PAD and carries a high (up to 55%) one-year risk of major vascular events. The principal target of this investigation was cadmium, a toxic atherogenic transition metal of which the principal environmental sources are smoking and diet. The present study suggests that cadmium accumulation may be a quantitative risk factor for graded development of symptomatic disease of the lower extremities, from low cadmium burden in CAD only, intermediate cadmium burden in CAD+simple PAD, and highest cadmium burden in the most severe form of PAD – CLI.

Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis

Title Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis
Journal The BMJ
Authors Chowdhury R, Ramond A, O’Keeffe L, et al.
Year Published 2018
Link to article

Abstract
This systematic review and meta-analysis of epidemiological studies investigating the association of arsenic, lead, cadmium, mercury, and copper with cardiovascular disease concludes that exposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioral risk factors.

Low-level lead exposure and mortality in US adults: a population-based cohort study

 

Title Low-level lead exposure and mortality in US adults:
a population-based cohort study
Journal The Lancet Public Health
Authors Lanphear BP, Rauch S, Auinger P, Allen RW, Hornung RW
Year Published 2018
Link to article

Abstract
Lead exposure is a risk factor for cardiovascular disease mortality, but the number of deaths in the USA attributable to lead exposure is poorly defined. We aimed to quantify the relative contribution of environmental lead exposure to all-cause mortality, cardiovascular disease mortality, and ischaemic heart disease mortality. Our findings suggest that low-level environmental lead exposure is an important, but largely overlooked, risk factor for cardiovascular disease mortality in the USA. A comprehensive strategy to prevent deaths from cardiovascular disease should include efforts to reduce lead exposure.

Chelation Therapy as a Cardiovascular Therapeutic Strategy: the Rationale and the Data in Review

Title Chelation Therapy as a Cardiovascular Therapeutic Strategy: the Rationale and the Data in Review
Journal Cardiovascular Drugs and Therapy
Authors Mathew RO, Schulman-Marcus J, Nichols EL, Newman JD, Bangalore S, Farkouh M, Sidhu MS
Year Published 2017
Link to article

Abstract
Chelation therapy, typically used to remove heavy metal toxins, has also been controversially used as a treatment for coronary artery disease. The first Trial to Assess Chelation Therapy (TACT) aimed to provide evidence on chelation therapy’s potential for benefit or harm. Although TACT had some significant results, the trial does not provide enough evidence to recommend routine chelation therapy and has limitations. The second TACT was recently funded reigniting a discussion about the value of chelation therapy, its efficacy, and allocation of research resources. Despite limited evidence, patients continue to pursue chelation therapy as a treatment for coronary artery disease. As the medical community has a responsibility to understand all treatments patients pursue, it is important to comprehensively appraise chelation therapy for cardiovascular disease. Understanding the background of heavy metal toxicity, the putative target of chelation therapy, on the cardiovascular system is important to contextualize the role of chelation therapy in cardiovascular disease prevention. We review the clinical evidence of heavy metal toxicity and cardiovascular disease, and available clinical trial data on use of chelation therapy to minimize the cardiovascular burden of heavy metal toxicity.

Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT)

Title Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT)
Journal American Heart Journal
Authors Omar M. Issa, DO, Rhonda Roberts, MPH, Daniel B. Mark, MD, MPH, Robin Boineau, MD, Christine Goertz, DC, PhD, Yves Rosenberg, MD, MPH, Eldrin F. Lewis, MD, Erminia Guarneri, MD, Jeanne Drisko, MD, Allan Magaziner, DO, Kerry L. Lee, PhD, Gervasio A. Lamas, MD
Year Published 2018
Link to article

Abstract
In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen tested was substantially different from any vitamin regimen tested in prior clinical trials. High-dose oral multivitamin and multimineral supplementation seem to decrease combined cardiac events in a stable, post-MI population not taking statin therapy at baseline. These unexpected findings are being retested in the ongoing TACT2.

Enhanced vasculotoxic metal excretion in post-myocardial infarction patients following a single edetate disodium-based infusion.

Title Enhanced vasculotoxic metal excretion in post-myocardial infarction patients following a single edetate disodium-based infusion.
Journal Environmental Research
Authors Ivan A. Arenasa, Ana Navas-Acienb, Ian Erguia, Gervasio A. Lamasa
Year Published 2017
Link to article

Abstract
Toxic metals have been associated with cardiovascular mortality and morbidity. We have hypothesized that enhanced excretion of vasculotoxic metals might explain the positive results of the Trial to Assess Chelation Therapy (TACT). The purpose of this study was to determine whether a single infusion of the edetate disodium based infusion used in TACT led to enhanced excretion of toxic metals known to be associated with cardiovascular events.

Chronic Toxic Metal Exposure and Cardiovascular Disease: Mechanisms of Risk and Emerging Role of Chelation Therapy

Title

Chronic Toxic Metal Exposure and Cardiovascular Disease: Mechanisms of Risk and Emerging Role of Chelation Therapy

Journal Current Atherosclerosis Reports
Authors Ehimen C. Aneni; Esteban Escolar; Gervasio A. Lamas
Year Published 2016
Link to article

This review summarizes the most recent evidence linking chronic toxic metal exposure to cardiovascular disease and examines the findings of TACT.

Heavy Metals, Cardiovascular Disease, and the Unexpected Benefits of Chelation Therapy

Title Heavy Metals, Cardiovascular Disease, and the Unexpected Benefits of Chelation Therapy
Journal Journal of the American College of Cardiology
Authors Lamas GA, Navas-Acien A, Mark DB, Lee KL
Year Published 2016
Link to article

Abstract
This review summarizes evidence from 2 lines of research previously thought to be unrelated: the unexpectedly positive results of TACT (Trial to Assess Chelation Therapy), and a body of epidemiological data showing that accumulation of biologically active metals, such as lead and cadmium, is an important risk factor for cardiovascular disease.