title: Metal pollutants and cardiovascular disease: mechanisms and consequences of exposure.
abstract: BACKGROUND
  There is epidemiological evidence that metal contaminants may play a role in the development of atherosclerosis and its complications. Moreover, a recent clinical trial of a metal chelator had a surprisingly positive result in reducing cardiovascular events in a secondary prevention population, strengthening the link between metal exposure and cardiovascular disease (CVD). This is, therefore, an opportune moment to review evidence that exposure to metal pollutants, such as arsenic, lead, cadmium, and mercury, is a significant risk factor for CVD.
  
  
  METHODS
  We reviewed the English-speaking medical literature to assess and present the epidemiological evidence that 4 metals having no role in the human body (xenobiotic), mercury, lead, cadmium, and arsenic, have epidemiologic and mechanistic links to atherosclerosis and CVD. Moreover, we briefly review how the results of the Trial to Assess Chelation Therapy (TACT) strengthen the link between atherosclerosis and xenobiotic metal contamination in humans.
  
  
  CONCLUSIONS
  There is strong evidence that xenobiotic metal contamination is linked to atherosclerotic disease and is a modifiable risk factor.
authors.affiliation: Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL.
authors.forename: Natalia V
authors.initials: NV
authors.lastname: Solenkova
authors.affiliation: Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Newman
authors.affiliation: Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Berger
authors.affiliation: Nelson Institute of Environmental Medicine, New York University School of Medicine, New York, NY.
authors.forename: George
authors.initials: G
authors.lastname: Thurston
authors.affiliation: Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Hochman
authors.affiliation: Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL; Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach FL.
authors.forename: Gervasio A
authors.initials: GA
authors.lastname: Lamas
mesh_terms: D001151:Arsenic / Q000009:adverse effects; D002104:Cadmium / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy; D015913:Chelation Therapy / Q000379:methods*; D002986:Clinical Trials as Topic; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D004785:Environmental Pollutants / Q000009:adverse effects*; D006801:Humans; D007854:Lead / Q000009:adverse effects; D008628:Mercury / Q000009:adverse effects; D008670:Metals / Q000009:adverse effects*; D012307:Risk Factors; D015262:Xenobiotics / Q000009:adverse effects
chemical_list: D004785:Environmental Pollutants; D008670:Metals; D015262:Xenobiotics; D002104:Cadmium; D007854:Lead; D008628:Mercury; D001151:Arsenic