The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography

Abstract

Background Lead exposure is a known risk factor for cardiovascular disease (CVD), and coronary artery calcification (CAC) is a biomarker for diagnosing atherosclerotic CVD. This study investigated the association between blood lead level (BLL) and CAC using coronary computed tomography (CT) angiography. Methods This study enrolled 2,189 participants from the general population with no history or symptoms of CVD. All participants underwent coronary CT angiography, health examination, and BLL testing. The association between coronary artery calcium score (CACS) and BLL was analyzed. Results The arithmetic mean of BLL was 2.71 ± 1.26 μg/dL, and the geometric mean was 2.42 (1.64) μg/dL, ranging from 0.12 to 10.14 μg/dL. There was a statistically significant positive correlation between CACS and BLL ( r = 0.073, P < 0.001). Mean BLLs among predefined CACS categories were as follows: absent grade (CACS = 0), 2.67 ± 1.23 μg/dL; minimal grade (> 0, < 10), 2.81 ± 1.25 μg/dL; mild grade (≥ 10, < 100), 2.74 ± 1.29 μg/dL; moderate grade (≥ 100, < 400), 2.88 ± 1.38 μg/dL; severe grade (≥ 400): 3.22 ± 1.68 μg/dL. The odds ratio for severe CAC was 1.242 in association with an 1 μg/dL increase in BLL ( P = 0.042). Conclusion Using coronary CT angiography, we determined a positive correlation between BLL and CAC among participants without CVD from the general population. To reduce the burden of CVD, efforts and policies should be geared toward minimizing environmental lead exposure.

Metals on the Menu—Analyzing the Presence, Importance, and Consequences

“…A newly published cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS) [ 205 ], including 5622 middle-aged men and women, found blood lead levels to be associated with an 8% increased risk of carotid artery plaque, as a predictive marker of clinical atherosclerosis. These results are in line with other studies showing an association between body lead levels and different markers of atherosclerosis, like coronary artery calcification [ 206 ] and intima–media thickness (IMT) [ 207 ]. The systematic review and meta-analysis of Chowdhury et al [ 208 ] explored the link between cardiovascular disease risk and toxic metals.…”