Preventive Cardiology

Microplastics, Nanoplastics, and Major Cardiac Events

A landmark NEJM study revealed that many patients with carotid artery disease might have microplastics and nanoplastics (MNPs) embedded in their carotid plaque, and those patients  have a massive 4.5-fold greater risk of heart attack, stroke, or death within three years.

The researchers examined carotid plaque specimens from 257 patients with asymptomatic carotid artery disease, analyzing their plaque for the presence of 11 MNPs, and tracking the patients’ cardiovascular outcomes over 34 months.

  • An alarming 58.4% of patients had polyethylene in their plaque and 12.1% had polyvinyl chloride in their plaque, while no patients had detectable levels of the nine other kinds of plastics. 
  • Even more alarming, 20% of patients with MNPs experienced the primary endpoint (myocardial infarction, stroke, or all-cause death), versus 7.5% in patients without MNPs in their plaque. 
  • After adjusting for variables (e.g. age, BMI, comorbidities, prior events), the presence of MNPs in plaque came with a 4.5-times higher risk of experiencing one of the primary events. Yikes.

The scientists also discovered visual evidence of MNPs’ damage to plaque, as electron microscopy showed “visible, jagged-edged foreign particles” in the MNP-containing plaques and those plaques appeared “more vulnerable, more inflamed.”

None of this sounds good, and clinicians and scientists across social media were extremely alarmed by these findings. 

However, there isn’t enough evidence to confirm that microplastics in plaque directly cause cardiovascular events, for example, the factors that helped introduce the MNPs into these patients (e.g. air pollution) could have had significant overall impacts on their health.

The Takeaway

It’s been quite a while since a study inspired such online uproar, and although we don’t know for sure that microplastics in plaque cause cardiovascular events, we have solid evidence that these patients are much more likely to experience them. We also know that their plaque appears more vulnerable. 

Let’s hope future studies lead to a better understanding of how microplastics are making it into our bodies and the harm they are causing — and they inspire action that leads to fewer and cleaner plastics.

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