Heart failure & cardiomyopathiesCohort study
Associations Between Urinary Metal Levels and Incident Heart Failure
- Prospective cohort study (pooled analysis of 3 cohorts)
- multicohort
- fixed effects meta-analysis
Authors' conclusion
Urinary metals are risk factors of HF across 3 diverse populations
Study context
- Population
- Adults 18–85 years in 3 geographically and ethnically/racially diverse cohorts, followed up to 20 years1,001 developed heart failure (HF)
- Participants
- 6,601 / 2,917 / 1,300
- Exposure
- Higher vs lower urinary metal levels
- MESAn = 6,601
- SHSn = 2,917
- Hortegan = 1,300
- Outcome
- Incident HF
- Follow-up
- Up to 20 years
Main finding
As reported in the abstract
Incident HF per doubling of urinary metal (pooled, adjusted)
Hazard ratio (95% CI)
Cadmium (per doubling)
1.15(1.07–1.24)
Molybdenum (per doubling)
1.13(1.05–1.22)
Zinc (per doubling)
1.22(1.14–1.32)
Per doubling, as printed
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident HF per 1 IQR increase in multi-metal mixture (fully adjusted) — MESA | 1.38 (1.00–1.86) | |
| Incident HF per 1 IQR increase in multi-metal mixture (fully adjusted) — SHS | 1.55 (1.28–1.97) | |
| Incident HF per 1 IQR increase in multi-metal mixture (fully adjusted) — Hortega | 1.08 (0.85–1.63) | |
| 0.512Hazard ratio (log scale) |
Incident HF stratified by LVEF (subset)
- Consistent with the pooled results
Original publication
Associations Between Urinary Metal Levels and Incident Heart Failure. JACC Heart Fail. Published 17 June 2025. doi:10.1016/j.jchf.2025.03.046
Summarised from the published abstract; every number is checked against it