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Media type:
E-Article
Title:
Serum copper levels and risk of major adverse cardiovascular events: a systematic review and meta-analysis
Contributor:
Muñoz-Bravo, Carlos;
Soler-Iborte, Eva;
Lozano-Lorca, Macarena;
Kouiti, Malak;
González-Palacios Torres, Carla;
Barrios-Rodríguez, Rocío;
Jiménez-Moleón, José Juan
imprint:
Frontiers Media SA, 2023
Published in:Frontiers in Cardiovascular Medicine
Language:
Not determined
DOI:
10.3389/fcvm.2023.1217748
ISSN:
2297-055X
Origination:
Footnote:
Description:
<jats:sec><jats:title>Background</jats:title><jats:p>Despite the fact that several studies have investigated the association between serum copper levels (S-Cu) and the risk of cardiovascular diseases, this relationship remains unclear. The aims of this study were to investigate the association between S-Cu and risk of major adverse cardiovascular events (MACE), including total stroke, ischemic stroke, hemorrhagic stroke, myocardial infarction and cardiovascular mortality, and identify potential sources of results heterogeneity.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We carried out a systematic review and meta-analysis. The selection criteria were: (1) Observational studies (cohort studies, case-control studies and hybrid studies); (2) Studies containing quantitative data about the relationship between S-Cu and risk of MACE; (3) Estimating association measures; and (4) Studies written in English, French or Spanish. Overall pooled Odds ratio (pOR) and 95% confidence intervals (95% CI) of MACE for the highest vs. lowest S-Cu category were calculated using random-effects models.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Sixteen studies with a total of 41,322 participants were included in the meta-analysis: 10 prospective cohort studies, 5 nested case-control studies and 1 case-control study. Comparing highest vs. lowest category, high S-Cu levels were associated with total stroke (pOR: 1.49, 95% CI 1.22–1.82; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%, <jats:italic>p</jats:italic> = 0.54), myocardial infarction (pOR: 1.31, 95% CI 1.17–1.46; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0.0%, <jats:italic>p</jats:italic> = 0.92) and cardiovascular mortality (pOR: 1.60, 95% CI 1.39–1.86; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0.0%, <jats:italic>p</jats:italic> = 0.54). Subgroup analysis showed that studies with a hybrid design had higher risks for cardiovascular mortality (pOR: 3.42, 95% CI 1.98–5.92) and ischemic stroke (pOR: 1.54, 95% CI 1.30–1.83).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>High S-Cu levels were associated with an increased risk of total stroke, myocardial infarction and cardiovascular mortality. Hybrid studies seems to modify the strength of the association between S-Cu and the risk of cardiovascular mortality and ischemic stroke.</jats:p></jats:sec><jats:sec><jats:title>Systematic review registration</jats:title><jats:p>[<jats:ext-link>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022370782</jats:ext-link>], identifier [CRD42022370782].</jats:p></jats:sec>