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Micro- and nano-plastics in the coronary circulation and air pollution exposure in ischaemic heart disease presentation
Summary
Doctors found tiny plastic particles (microplastics) in the blood vessels of heart attack patients far more often than in people with milder heart disease or healthy hearts — and these particles showed up alongside higher inflammation levels, more air pollution exposure, and smoking. While this doesn't prove plastics *cause* heart attacks, it adds to growing evidence that the plastic and pollution we're exposed to daily may be building up in our bodies and could be linked to heart disease risk, making a case for reducing plastic and air pollution exposure where possible.
Abstract Background and Aims Micro- and nanoplastics (MNPs) are emerging risk factors for cardiovascular diseases. The present study aimed to evaluate the burden of MNPs in coronary blood across the spectrum of coronary artery disease (CAD), and their association with air pollution exposure and inflammation. Methods Cross-sectional study, including 61 consecutive patients undergoing coronary angiography for suspected CAD, stratified into: ST-segment elevation myocardial infarction (STEMI, n = 19), chronic coronary syndromes (CCS, n = 20), and controls with normal coronary arteries (n = 22). MNPs were quantified in coronary and peripheral blood using pyrolysis-gas chromatography-mass spectrometry and laser direct infrared spectroscopy. Air pollution exposure data were collected on the day of the invasive procedure (acute exposure) and over the preceding 2 years (chronic exposure). Results MNPs were detected significantly more frequently in STEMI patients (84.2%) than in CCS (40%) and controls (31.8%) (P = .002), with higher concentration and greater polymer diversity [median of 3 polymers (interquartile range: 2–4), P < .001]. Polyethylene was the predominant polymer (97%). The same polymers were consistently identified in peripheral and coronary blood samples from individual patients, with the highest concentrations in coronary blood (P < .001). STEMI patients showed higher levels of interleukin-6 and tumour necrosis factor-α (P≤.006) and were exposed to higher levels of PM2.5 (P≤.012). MNP detection was more frequent among smokers and patients exposed to PM2.5 > 15 µg/m3 (P = .006), with all patients presenting both factors showing detectable MNPs (P < .001). In multivariable analysis, smoking history emerged as the only independent predictor of MNP presence (odds ratio 5.69, 95% confidence interval 1.33–26.63, P = .023). Conclusions STEMI patients exhibited a greater burden of MNPs in coronary blood than CCS and controls. MNP detection frequently co-occurred with elevated inflammatory biomarkers, greater PM2.5 exposure, and smoking, suggesting a potential association between environmental exposure and CAD.