{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:34:24Z","timestamp":1773416064631,"version":"3.50.1"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005117","name":"Birjand University of Medical Sciences","doi-asserted-by":"publisher","award":["IR.BUMS.REC.1399.072"],"award-info":[{"award-number":["IR.BUMS.REC.1399.072"]}],"id":[{"id":"10.13039\/501100005117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec030\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cerebrovascular accidents (CVAs) are among the most common complications of patients today. As the prevalence of ischemic CVAs rises, detecting related risk factors is crucial. Metal concentration has previously been considered a major risk factor in several neural complications, and in this study, we will investigate this.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec031\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this case-control study, 70 CVA (clinically approved ischemic stroke cases by imaging and NIH Stroke Scale (NIHSS)) and 70 individuals with no history of CVA controls were enrolled as the control group. The serum level of several metals, including Fe (Iron), Co (Cobalt), Ni (Nickel), Cu (copper), Zn (Zinc), Mn (Manganese), Pb (lead), Hg (Mercury), has been assessed using Inductively coupled plasma mass spectrometry (ICP-MS) method. Logistic regression (LR) has also been used to determine the association between metals\u2019 levels and CVA occurrence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec032\">\n<jats:title>Results<\/jats:title>\n<jats:p>As the mean age of the CVA group was 48.68\u2009 \u00b1 \u200915.25 years and for the non-CVA group was 47.89\u2009\u00b1\u20099.65 years, the result indicated that the serum level of Cu and Pb has been statically higher in the CVA group (respectively; P\u2009 &lt;\u2009 0.001 and P\u2009 =\u2009 0.002) and Ni level was significantly lower (P\u2009 = \u20090.003). Other measured metals\u2019 levels (Fe, Co, Ni, Mn, Hg) were not significantly different between CVA and non-CVA groups. In the LR model, all Cu, Pb, and Zn metals had a P value of 0.03 and an odd ratio (OR) and confidence interval (CI) of 1.34 (1.02\u20131.75), 1.19 (1.01\u20131.39) and 1.01 (1.001\u20131.02) respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec033\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Given that some metals are associated with a higher risk of CVA, researchers and physicians must better understand the risk factors and causes of the burden of CVA. However, further studies with a larger population and investigation of the exact pathogenesis of these metals are needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0317731","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T18:52:38Z","timestamp":1738608758000},"page":"e0317731","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cerebrovascular accidents association between serum trace elements and toxic metals level, a case-control 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