Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.
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Marfella Raffaele, Prattichizzo Francesco, Sardu Celestino, Fulgenzi Gianluca, Graciotti Laura, Spadoni Tatiana, D'Onofrio Nunzia, Scisciola Lucia, La Grotta Rosalba, Frigé Chiara, Pellegrini Valeria, Municinò Maurizio, Siniscalchi Mario, Spinetti Fabio, Vigliotti Gennaro, Vecchione Carmine, Carrizzo Albino, Accarino Giulio, Squillante Antonio, Spaziano Giuseppe, Mirra Davida, Esposito Renata, Altieri Simona, Falco Giovanni, Fenti Angelo, Galoppo Simona, Canzano Silvana, Sasso Ferdinando C, Matacchione Giulia, Olivieri Fabiola, Ferraraccio Franca, Panarese Iacopo, Paolisso Pasquale, Barbato Emanuele, Lubritto Carmine, Balestrieri Maria L, Mauro Ciro, Caballero Augusto E, Rajagopalan Sanjay, Ceriello Antonio, D'Agostino Bruno, Iovino Pasquale, Paolisso Giuseppe
Аннотация
METHODS: We conducted a prospective, multicenter, observational study involving patients who were undergoing carotid endarterectomy for asymptomatic carotid artery disease. The excised carotid plaque specimens were analyzed for the presence of MNPs with the use of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Inflammatory biomarkers were assessed with enzyme-linked immunosorbent assay and immunohistochemical assay. The primary end point was a composite of myocardial infarction, stroke, or death from any cause among patients who had evidence of MNPs in plaque as compared with patients with plaque that showed no evidence of MNPs.
RESULTS: A total of 304 patients were enrolled in the study, and 257 completed a mean (±SD) follow-up of 33.7±6.9 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4%), with a mean level of 21.7±24.5 μg per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2±2.4 μg per milligram of plaque. Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine. Patients in whom MNPs were detected within the atheroma were at higher risk for a primary end-point event than those in whom these substances were not detected (hazard ratio, 4.53; 95% confidence interval, 2.00 to 10.27; P<0.001).
CONCLUSIONS: In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected. (Funded by Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale and others; ClinicalTrials.gov number, NCT05900947.).