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Plastic in Atherosclerotic Plaque

More than 400 million tons of plastic are produced each year from fossil fuels. Plastics are used in food packaging, water bottles, containers, clothes, plumbing, medical tubing, blood bags. They shed microscopic particles that can be ingested or inhaled by people. Previous studies have been found microplastics in in the colon, liver, lymph nodes, spleen, lung, testes, ovaries, breast milk, and placenta. Microplastics have been linked with asthma, cognitive impairment, interstitial lung disease, cancer, infertility, endocrine disruption, and premature births.

A new prospective study from 3 medical centers in Italy has found microplastics and nanoplastics (MNP) in atherosclerotic plaques removed from carotid arteries. A total of 304 patients underwent carotid endarterectomy and 257 of these patients were followed for nearly 3 years. The baseline characteristics of participants with or without MNP were matched for age, sex, atherosclerotic risk factors, lipid levels, and medications.

Electron microscopy detected MNP in the plaque of 58% of the patients. Chemical analysis revealed that most of the particles were composed of either polyethylene or polyvinyl chloride.The MNP caused a marked increase in inflammatory molecules in the plaque. Levels of TNF-alpha, Interleukin-6, Interleukin-18, interleukin 1-beta, CD3 and CD68 were increased.

Patients with MNP and increased inflammatory markers had a 4.5 fold increase in stroke, myocardial infarction, and death from all causes. This preliminary study raises the question as to whether exposure to plastic should be considered a cardiovascular risk factor.


Raffaele M et al. Microplastics and Nanoplastis in Atheromas and Cardiovascular Events. N Engl J Med March 7, 2024;390:900-910. DOI: 10.1056/NEJMoa2309822

Topol E. There’s Plastic in My Plaque!, Ground Truths, Substack, March 6, 2024

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