Blood and urine levels of heavy metal pollutants in female and male patients with coronary artery disease

Abstract

Michael Sponder,1 Monika Fritzer-Szekeres,2 Rodrig Marculescu,2 Martina Mittlböck,3 Maria Uhl,4 Birgit Köhler-Vallant,5 Jeanette Strametz-Juranek1 1Department of Cardiology, Medical University of Vienna, Vienna, Austria; 2Department of Medical-Chemical Laboratory Analysis, Medical University of Vienna, Vienna, Austria; 3Department of Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria; 4Department of Pollutants and Human, Environment Agency Austria, Vienna, Austria; 5Department of Inorganic Analysis, Environment Agency Austria, Vienna, Austria Background: Heavy metal pollutants such as cadmium (Cd), lead (Pb), and mercury (Hg) are rarely the subjects of cardiovascular research although they have been suspected for decades to negatively impact the circulatory system. Methods: Apart from detailed anamnestic data, urinary levels of Cd and full blood levels of Pb and Hg were measured in 53 female (mean age: 68.04±7.03 years) and 111 male (mean age: 60.68±11.43 years) nonsmoking or never-smoking patients with angiographically verified and precisely quantified coronary artery disease (CAD). Results: Although Cd was quantifiable in 68.3% of subjects, only 34.1% of these patients exceeded the critical 1 µg/L Human Biomonitoring (HBM)-I level. Median Pb (20 µg/L) and Hg (0.55 µg/L) levels were lower than the HBM-I, as well as reference levels of Pb. Wine consumption was the main source for Pb, fish and wine consumption for Hg, and previous nicotine abuse for Cd. There was no correlation between Cd, Pb, or Hg and severity of CAD although severity correlated positively with atherosclerosis parameters (uric acid, creatinine, triglycerides, blood urea nitrogen, C-reactive protein) and negatively with high density lipoprotein cholesterol. Conclusion: Cd levels detected in CAD patients were high compared to German and European reference levels but it could not be proven that urine levels of Cd and blood levels of Hg or Pb played a major role in the genesis of CAD, particularly when compared to well-known biomarkers such as blood pressure, glucose, and lipids. Keywords: cadmium, plumbum, mercury, coronary artery disease, pollutants