RESEARCH ARTICLE
Is Cadmium Exposure Associated with the Burden, Vulnerability and Rupture of Human Atherosclerotic Plaques? Göran Bergström1☯, Björn Fagerberg1☯*, Gerd Sallsten2, Thomas Lundh3, Lars Barregard2 1 Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden, 2 Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden, 3 Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden ☯ These authors contributed equally to this work. * [email protected]
Abstract OPEN ACCESS Citation: Bergström G, Fagerberg B, Sallsten G, Lundh T, Barregard L (2015) Is Cadmium Exposure Associated with the Burden, Vulnerability and Rupture of Human Atherosclerotic Plaques?. PLoS ONE 10(3): e0121240. doi:10.1371/journal. pone.0121240 Academic Editor: Jaymie Meliker, Stony Brook University, Graduate Program in Public Health, UNITED STATES Received: September 24, 2014 Accepted: January 29, 2015 Published: March 27, 2015 Copyright: © 2015 Bergström et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data may be accessed by contacting the Swedish National Data Service with direct links (http://snd.gu.se/en/catalogue/study EXT0140; http://snd.gu.se/en/catalogue/study/ EXT0141). These links show the titles of the data bases and below these titles an order box can be clicked, leading to a small form to be completed for requesting the data files. This request will then be forwarded to the responsible data base holder who will provide the reader with the requested data.
The general population is exposed to cadmium from food and smoking. Cadmium is a widely spread toxic pollutant that seems to be associated with cardiovascular diseases, although little is known if it contributes to the occurrence of atherosclerotic plaques and the process whereby plaques become vulnerable and are prone to rupture. We tested the hypotheses that cadmium exposure is associated not only with an increased subclinical burden of atherosclerotic plaques in different vascular territories and early signs of plaque vulnerability, but also with cadmium content and plaque-rupture in the clinical phase of the disease. Ultrasound technique was used to measure plaque prevalence and echogenicity in the carotid and femoral arteries in a population sample of women (n = 599) in whom blood cadmium was measured. In addition cadmium was measured in snap-frozen endarterectomies and whole blood obtained from patients who were referred to surgery because of symptomatic carotid plaques (n = 37). Sixteen endarterectomies were divided into three parts corresponding to different flow conditions and plaque vulnerability. In the population sample blood cadmium was associated with the number of vascular territories with plaques (p = 0.003 after adjustment for potential confounders). The cadmium concentrations in symptomatic plaques were 50-fold higher in plaque tissue than in blood. Cadmium levels in blood and plaque correlated, also after adjustment for smoking and other cardiovascular risk factors (p
Is Cadmium Exposure Associated with the Burden, Vulnerability and Rupture of Human Atherosclerotic Plaques? Göran Bergström1☯, Björn Fagerberg1☯*, Gerd Sallsten2, Thomas Lundh3, Lars Barregard2 1 Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden, 2 Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden, 3 Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden ☯ These authors contributed equally to this work. * [email protected]
Abstract OPEN ACCESS Citation: Bergström G, Fagerberg B, Sallsten G, Lundh T, Barregard L (2015) Is Cadmium Exposure Associated with the Burden, Vulnerability and Rupture of Human Atherosclerotic Plaques?. PLoS ONE 10(3): e0121240. doi:10.1371/journal. pone.0121240 Academic Editor: Jaymie Meliker, Stony Brook University, Graduate Program in Public Health, UNITED STATES Received: September 24, 2014 Accepted: January 29, 2015 Published: March 27, 2015 Copyright: © 2015 Bergström et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data may be accessed by contacting the Swedish National Data Service with direct links (http://snd.gu.se/en/catalogue/study EXT0140; http://snd.gu.se/en/catalogue/study/ EXT0141). These links show the titles of the data bases and below these titles an order box can be clicked, leading to a small form to be completed for requesting the data files. This request will then be forwarded to the responsible data base holder who will provide the reader with the requested data.
The general population is exposed to cadmium from food and smoking. Cadmium is a widely spread toxic pollutant that seems to be associated with cardiovascular diseases, although little is known if it contributes to the occurrence of atherosclerotic plaques and the process whereby plaques become vulnerable and are prone to rupture. We tested the hypotheses that cadmium exposure is associated not only with an increased subclinical burden of atherosclerotic plaques in different vascular territories and early signs of plaque vulnerability, but also with cadmium content and plaque-rupture in the clinical phase of the disease. Ultrasound technique was used to measure plaque prevalence and echogenicity in the carotid and femoral arteries in a population sample of women (n = 599) in whom blood cadmium was measured. In addition cadmium was measured in snap-frozen endarterectomies and whole blood obtained from patients who were referred to surgery because of symptomatic carotid plaques (n = 37). Sixteen endarterectomies were divided into three parts corresponding to different flow conditions and plaque vulnerability. In the population sample blood cadmium was associated with the number of vascular territories with plaques (p = 0.003 after adjustment for potential confounders). The cadmium concentrations in symptomatic plaques were 50-fold higher in plaque tissue than in blood. Cadmium levels in blood and plaque correlated, also after adjustment for smoking and other cardiovascular risk factors (p
