Plastic, the new cardiovascular risk factor?
Microplastics and Nanoplastics in Atheromas and Cardiovascular Events, Raffaele Marfella & al, N Engl J Med 2024; 390:900-910

Plastic, the new cardiovascular risk factor?

Plastic contamination is ubiquitous, infiltrating our lives from the earliest stages as evidenced by its presence in breast milk, containing particles of polyethylene, polyvinyl chloride, and polypropylene ranging from 2 to 12 μm (Polymers, 2022). Moreover, studies have detected PVC, nylon, and polyethylene in human placenta at concentrations ranging from 6.5 to 790 micrograms per gram of tissue (Env. Int., 2021).

The implications of plastic ingestion have taken a concerning turn with the recent publication by Raffaele Marfella et al. in the New England Journal of Medicine. Their study revealed a significant hazard ratio of 4.53 (2.0-10.27), p<0.001, indicating an increased risk of non-fatal myocardial infarction, non-fatal strokes, or all-cause death in patients with microplastics and nanoplastics integrated into the atherosclerotic plaques of their carotid arteries. In just 33 months of follow-up, the event rate per group was 7.5% in patients without plastic contamination detected during carotid plaque examination, but rose to 20% in patients with positive identification of polyvinyl chloride and polyethylene.

According to Dr. Giuseppe Paolisso, one of the study's authors, in an interview with The New York Times, microplastics and nanoplastics seem to render these plaques more fragile, increasing the risk of dislodgement from the artery wall.

While these results do not conclusively establish causality, they raise important questions regarding the evaluation of cardiovascular risk factors in patients. Identifying plastic contamination in patients may emerge as a crucial consideration in cardiovascular clinical trials, potentially influencing clinical outcomes, underscoring the need for further research into their impact on cardiovascular health.

https://www.nejm.org/doi/full/10.1056/NEJMoa2309822

https://www.nytimes.com/2024/03/09/health/microplastics-sxsw-health-plastic-people.html?searchResultPosition=1

Olivier GRYSON

Global Head Digital Healthcare at Abbott (Medicines)

8 个月

What worries me the most is that we consider patients who were exposed to plastic much later in life than the young generations we have today as the amount of microparticles of plastic keeps increasing. Further studies might show an even more dramatic picture of the situation.

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