Coronary Intravascular Micro- and Nanoplastic Burden Across the Spectrum of Coronary Artery Disease

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Summary of  European Heart Journal  https://doi.org/10.1093/eurheartj/ehag447 
Dr. Pasquale Paolisso  et al.

Points

European Heart Journal research led by Sapienza University evaluated 61 patients undergoing coronary angiography to determine micro- and nanoplastic presence within coronary circulation.
Laboratory analysis detected circulating micro- and nanoplastics in 84% of acute heart attack patients, compared with 40% of chronic ischemic disease patients and 32% of healthy controls.
Tobacco smoking increased the likelihood of microplastic detection sixfold, while long-term ambient fine particulate matter exposure further accelerated particle uptake into human arterial blood.
Environmental exposure analysis revealed that all smoking patients living in higher air pollution areas had blood microplastics, compared to just 12.5% of non-smoking, low-pollution controls.
Presence of circulating polyethylene and other plastics correlated with elevated inflammatory biomarkers, including tumor necrosis factor-α and interleukin-6, suggesting environmental contamination accelerates vascular injury.

Summary

This study evaluated the prevalence and concentration of micro- and nanoplastics (MNPs; particle dimensions under 5 mm and under 1 μm, respectively) within the coronary circulation across the clinical spectrum of coronary artery disease. Given that environmental exposures may accelerate atherogenesis through systemic inflammation, researchers assessed systemic and coronary blood samples from 61 patients undergoing coronary angiography. Patients were stratified into acute ST-segment elevation myocardial infarction (STEMI), chronic coronary syndromes (CCS), or control groups with normal coronary arteries to determine whether intravascular MNP presence correlates with acute ischemic events.

The analysis demonstrated a marked gradient in MNP detection rates across clinical presentations. Coronary MNPs were detected in 84% of STEMI patients, compared to 40% of CCS patients and 32% of control subjects with normal coronary arteries. Polyethylene was identified as the predominant polymer type. Environmental and lifestyle risk factors strongly modulated MNP burden; smokers exhibited a 6-fold increase in blood MNP probability, while higher long-term ambient fine particulate matter exposure (PM2.5) significantly increased MNP presence. Notably, 100% of smoking patients with elevated PM2.5 exposure harbored intravascular plastics, whereas only 12.5% of non-smoking, low-exposure controls tested positive.

Presence of MNPs was accompanied by elevated inflammatory biomarkers, specifically tumor necrosis factor-α and interleukin-6. While these findings establish a strong clinical association rather than direct causation, they indicate that inhaled or ingested environmental plastic pollutants enter the systemic circulation, exacerbate vascular inflammation, and correlate with acute ischemic event presentation. Clinicians should recognize environmental pollutant exposures as emerging components of the cardiovascular exposome, warranting further mechanistic investigation and broader public health mitigation strategies.

Link to the article: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag447/8725569?login=false

References

Paolisso, P., Scisciola, L., Belmonte, M., Scarsini, R., Galli, V., Gallinoro, E., Casenghi, M., Ausiello, D., Vincelli, G., Policastro, P., Redivo, M., Cefalì, F., Fenti, A., Pellegrini, V., Falco, G., Galoppo, S., Berni, A., Armillotta, M., Pizzi, C., … Barbato, E. (2026). Micro- and nano-plastics in the coronary circulation and air pollution exposure in ischaemic heart disease presentation. European Heart Journal, ehag447. https://doi.org/10.1093/eurheartj/ehag447