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Microplastics and Nanoplastics in Atheromas and Cardiovascular Events

Wednesday, April 10, 2024

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Source Name: The New England Journal of Medicine


Raffaele Marfella, Francesco Prattichizzo, Celestino Sardu, Gianluca Fulgenzi, Laura Graciotti, Tatiana Spadoni, Nunzia D’Onofrio, Lucia Scisciola, Rosalba La Grotta, Chiara Frigé, Valeria Pellegrini, Maurizio Municinò, Mario Siniscalchi, Fabio Spinetti, Gennaro Vigliotti, Carmine Vecchione, Albino Carrizzo, Giulio Accarino, Antonio Squillante, Giuseppe Spaziano, Davida Mirra, Renata Esposito, Simona Altieri, Giovanni Falco, Angelo Fenti, Simona Galoppo, Silvana Canzano, Ferdinando C. Sasso, Giulia Matacchione, Fabiola Olivieri, Franca Ferraraccio, Iacopo Panarese, Pasquale Paolisso, Emanuele Barbato, Carmine Lubritto, Maria L. Balestrieri, Ciro Mauro, Augusto E. Caballero, Sanjay Rajagopalan, Antonio Ceriello, Bruno D’Agostino, Pasquale Iovino, and Giuseppe Paolisso

In preclinical studies, microplastics and nanoplastics have been found to be a potential risk factor for cardiovascular disease. However, there is a lack of clinical evidence that this risk extends to humans. The authors conducted a prospective, multicenter, observational study involving patients undergoing carotid endarterectomy. The excised carotid plaque specimens were analyzed for microplastics and nanoplastics. The primary endpoint of a composite of myocardial infarction, stroke, or death from any cause was compared among patients with evidence of microplastics and nanoplastics in plaque as compared against patients with a plaque that showed no evidence of microplastics and nanoplastics. A total of 304 patients were enrolled in the study, and 257 completed a mean follow up of 34 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4 percent), with a mean level of 21.7 μg per milligram of plaque. A total of 31 patients (12.1 percent) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2 μg per milligram of plaque. Patients in whom microplastics and nanoplastics were detected within the atheroma were at higher risk for a primary endpoint event than those in whom these substances were not detected (hazard ratio, 4.53; 95 percent confidence interval, 2.00 to 10.27; P<0.001).

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