Patients who suffer heart attack have more micro and nanoplastic in their blood
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People who suffered a serious heart attack had higher levels of micro- and nanoplastics in their blood compared with patients diagnosed with chronic ischemic heart disease and those with normal blood vessels supplying the heart, according to a study published in the European Heart Journal on Wednesday.
The study also revealed that people who smoke and people exposed to higher levels of air pollution had higher levels of micro- and nanoplastics in their blood.
The researchers say the study adds to growing evidence that environmental pollution may affect cardiovascular health.
This study is a collaboration between researchers at Sapienza University of Rome, the University of Verona and the Research Centre on Environmental Pollution and Cardiovascular Diseases at the University of Campania "Luigi Vanvitelli" in Naples, Italy, a center dedicated to understanding how environmental pollutants influence cardiovascular health.
The study's first author, Dr. Pasquale Paolisso of Sant'Andrea Hospital, Sapienza University of Rome, Italy, said, "Micro- and nanoplastics are tiny plastic particles that are found virtually everywhere in the environment, including the air we breathe, the water we drink and many foods we consume. In recent years, scientists have begun to detect these particles in human tissues and organs, raising concerns about their potential health effects.
"However, very little was known about whether these particles are present in the coronary circulation—the blood flowing through the arteries that supply the heart—or whether environmental exposures such as smoking and air pollution might influence their presence."
The study included 61 patients at Sant'Andrea University Hospital or Azienda Ospedaliera Universitaria Integrata of Verona, Italy, who were diagnosed with either a heart attack, chronic ischemic heart disease or normal coronary arteries.
Researchers took samples of the patients' blood from the blood vessels supplying the heart and from elsewhere in the body. They also collected data on whether the patients smoked and their exposure to pollution, both on the day of testing and over the preceding two years.
Coronary micro- and nanoplastics were analyzed at the Research Centre for Environmental Pollution and Cardiovascular Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.
Among those who had heart attacks, micro- and nanoplastics were detected in 84% of patients, compared with 40% of patients with chronic ischemic heart disease and 32% of patients with normal coronary arteries. Heart attack patients had a greater variety of plastic types in their blood. The most common type of plastic was polyethylene, which is commonly used in packaging and consumer products.
Patients exposed to higher long-term levels of air pollution (PM2.5/particles measuring 2.5 μm or less in diameter) were more likely to have microplastics in their blood, and smokers were six times more likely to have microplastics in their blood. All patients who smoked and were exposed to higher air pollution levels had plastics in their blood, compared with only 12.5% of patients who did not smoke and were not exposed to higher levels of air pollution.
The research was led by professor Emanuele Barbato of Sapienza University of Rome and director of the Cardiology Unit of Sant'Andrea University Hospital, Rome, Italy. He said, "These findings do not prove that microplastics cause heart attacks, but they reveal a strong association between environmental exposures, microplastics in the blood and cardiovascular disease.
"In our study, smoking history was strongly linked to microplastics in the blood. Our findings suggest that smoking might make it easier for micro- and nanoplastics to enter the bloodstream via the lungs. Air pollution may act in a similar way.
"The results highlight the need to consider microplastic pollution as part of the broader environmental determinants of health. Policies that reduce air pollution, tobacco exposure and environmental plastic contamination could have benefits that extend beyond environmental protection and potentially improve cardiovascular health."
In an accompanying editorial, professor Andreas Daiber of University Medical Centre of the Johannes Gutenberg University, Mainz, Germany, and colleagues said, "Over time, plastics fragment into microplastics (<5 mm) and nanoplastics (<1 μm), which are now detected in virtually all environmental compartments, including air, water and soil. Increasingly, these particles are also found within the human body, including blood, lung tissue, placenta and breast milk, indicating systemic exposure.
"Until recently, the cardiovascular effects of plastic exposure were largely speculative. However, emerging clinical evidence now suggests a potential link between NMPs and cardiovascular disease. In patients undergoing carotid endarterectomy, NMPs were detected within atherosclerotic plaques, and their presence was associated with an increased risk of myocardial infarction, stroke and all-cause mortality.
"In their study published in this issue of the European Heart Journal, Paolisso's team investigated 61 patients undergoing coronary angiography for suspected coronary artery disease. Patients were categorized into ST-segment elevation myocardial infarction (STEMI), chronic coronary syndromes (CCS) and controls. Using advanced analytical methods, NMPs were detected in both peripheral and coronary blood.
"Notably, plastic particle concentrations were highest in STEMI patients, intermediate in those with CCS and lowest in controls. These findings were accompanied by elevated inflammatory markers, including tumor necrosis factor-α and interleukin-6, suggesting a link between plastic exposure and systemic inflammation. Although limited by sample size, these findings represent early clinical evidence that plastic particles may be associated with acute cardiovascular events.
"NMPs represent a rapidly emerging environmental exposure with potentially important implications for cardiovascular health. Early clinical evidence demonstrates that plastic particles can enter the circulation and accumulate in vascular tissues, while experimental studies indicate that they trigger key mechanisms of vascular injury, including oxidative stress, inflammation and endothelial dysfunction.
"Although substantial uncertainties remain, the convergence of epidemiological, clinical and mechanistic evidence suggests that plastic pollution may represent a previously underestimated cardiovascular risk factor. Addressing this challenge will require coordinated efforts across disciplines and policy domains. In the era of the Anthropocene, protecting cardiovascular health will increasingly depend on reducing not only traditional risk factors but also the growing burden of environmental pollutants (the detrimental part of the exposome), among which plastics may soon play a central role."
Publication details
Micro- and nano-plastics in the coronary circulation and air pollution exposure in ischaemic heart disease presentation, European Heart Journal (2026). DOI: 10.1093/eurheartj/ehag447
Journal information: European Heart Journal
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