Postmortem Inductively Coupled Plasma Mass Spectrometry Analysis Reveals Elevated Heavy Metal Concentrations in Coronary Arteries: A Comparative Autopsy Study Supporting a Toxic Inflammatory Hypothesis for Atherosclerosis.

Abstract

Introduction: A large number of studies have been carried out for the etiology of atherosclerosis and many risk factors have been identified, including environmental factors and heavy metals, which are related to the pathogenesis. This study aimed to determine the effects of heavy metals, which have activation and inhibition effects on various metabolic pathways, on atherosclerosis by examining coronary arteries obtained from autopsy series.

Methods: Coronary arteries of 28 autopsy cases were analyzed by inductively coupled plasma mass spectrometry method. Sixteen of the cases had coronary atherosclerotic plaques and 12 of the coronaries were normal. Twenty trace metal concentrations were examined from the samples obtained.

Results: Twenty-eight coronary artery samples (16 with atherosclerosis, 12 normal) were analyzed using ICP-MS. Levels of Mg, K, Ca, P, Fe, Zn, Al, S, As, Pt, Sb, Hg were significantly higher in atherosclerotic arteries (e.g., Ca: 51,384 vs. 1,723 ppm, p = 0.005; P: 30,791 vs. 3,443 ppm, p = 0.003; Hg: 3.2 vs. 0 ppm, p < 0.001). Elements such as lead, cobalt, and cadmium remained below detection limits in both groups.

Conclusion: Heavy metals through inflammation, oxidative stress, and disrupted antioxidant pathways are independent risk factors that increase the risk of atherosclerosis. These findings provide tissue-level evidence that heavy metal accumulation may contribute to atherosclerosis through oxidative stress, inflammation, and disruption of antioxidant defenses.