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March 7, 2024
2 minute read
Important points:
- Patients with microplastics or nanoplastics in their carotid plaques were more likely to die or have a heart attack or stroke than those without.
- This finding supports previous in vitro and animal studies.
Among patients with asymptomatic carotid artery disease who underwent carotid endarterectomy, patients whose atheroma contained microplastics or nanoplastics had worse outcomes than those whose atheroma did not contain microplastics or nanoplastics. researchers reported.
Patients with carotid artery atheroma containing microplastics and nanoplastics (MNPs) had a more than four times higher risk of heart attack, stroke, or all-cause death nearly three years later than patients with no evidence of MNPs, a study found. they wrote in their paper. New England Medical Journal.
“Recent studies conducted in preclinical models suggest that MNPs are a new risk factor for cardiovascular disease.” LafFile Marfera, M.D., Ph.D. Luigi Vanvitelli of the School of Advanced Medical and Surgical Sciences at the University of Campania in Naples, Italy, and colleagues write. “However, the clinical relevance of these findings is unclear. There is a lack of evidence that MNPs infiltrate human vascular lesions or to support an association between MNP burden and cardiovascular disease. Atheroma. To investigate whether MNPs are detectable within atherosclerotic plaques and whether MNP burden is associated with cardiovascular disease, we used pyrolysis gas chromatography-mass spectrometry, stable isotope analysis, and electronic We assessed the presence of these materials in surgically excised carotid artery plaques using analysis microscopy.The presence of MNPs was then used to evaluate the presence of MNPs in a composite endpoint of myocardial infarction, stroke, or death from any cause. We determined whether it was related.
Researchers enrolled 304 patients with asymptomatic carotid artery disease undergoing carotid endarterectomy, 257 of whom completed an average follow-up of 33.7 months.
Marfella et al. detected polyethylene in the atheroma of 58.4% of patients (average level, 21.7 g/mg per plaque), and 12.1% of these patients’ atheroma contained measurable amounts of polyvinyl chloride (average level, 5.2 g/mg/mg). of the plaque). The average age of MNP users was 71 years, and 77.3% were male. The average age of those not undergoing MNP was 73 years, and 73.8% were male.
Electron microscopy showed the presence of “foreign bodies with visible jagged edges” within the plaque macrophages, scattered among external debris, and X-ray examination showed that some of these particles was also found to contain chlorine, the researchers wrote.
Compared with patients without MNPs, those with detected MNPs had more than 4 times higher risk of MI, stroke, or death during follow-up (20% vs 7.5%; HR = 4.53; 95% CI, 2-10.27; P < .001), according to the researchers.
“Our findings suggest that nanoplastics, rather than microplastics, may accumulate at sites of atherosclerosis,” the researchers wrote. “In fact, the majority of particles detected in this study were visible as scattered debris in the extracellular space, below the 200 nm threshold suggested for the intestine and other barriers. Consistent with the idea that absorption and distribution increase” as particle size decreases. ”
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Dr. Larry B. Goldstein, Fern, Fana, Farha
This is an important initial study showing an association between MNPs and cardiovascular disease outcomes. The main finding is that patients with evidence of her MNP within asymptomatic atherosclerotic carotid plaques are at increased risk for subsequent CV events. As the authors also point out, this does not necessarily mean that the two are causally related, as there may be other unmeasured factors that differ in the presence and absence of MNP. However, preclinical data provide some evidence for the vascular effects of MNPs.
At this time, it is unclear what can be done to prevent events associated with MNP. MNP is quite popular. Because there appears to be a relationship between MNP abundance and vascular events, it may be necessary to consider developing strategies to reduce exposure at the population level.
This study was limited to patients treated for asymptomatic carotid atherosclerosis. Extending the observations to other populations would provide further support for this association.
Dr. Larry B. Goldstein, Fern, Fana, Farha
Helio | Cardiology Today Editorial Board
Ruth L. Works Professor and Professor of Neurology
Associate Dean for Clinical Research, School of Medicine
Co-Director, Kentucky Neuroscience Institute
UK Neuroscience Research Priority Area Co-Director
Interim Director, Norton Stroke Care Network UK
KY Clinic – University of Kentucky
Disclosure: Goldstein does not report any relevant financial disclosures.
Information source/disclosure information
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Disclosure: One author reports receiving speaking fees from Berlin Chemie Menarini. Marfella and other authors do not report relevant financial disclosures.
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