Stroke patients have high levels of microplastics in the plaque clogging their arteries, researchers find

 What will your stroke medical 'professionals' do to alleviate this problem? NOTHING, LIKE USUAL!

Stroke patients have high levels of microplastics in the plaque clogging their arteries, researchers find

• Microplastics and nanoplastics might interact with the plaque that causes heart attacks and strokes.

• A new study found high levels of plastic in the arterial plaque of stroke and vision-loss patients.

• Cells in plastic-filled plaque also showed signs of altered gene activity, but it's unclear why.

Tiny, microscopic bits of plastic have been found almost everywhere researchers look — including throughout the human body.

Microplastics and their even tinier cousins, nanoplastics, are probably flowing through your blood and building up in your organs like the lungs and liver.

Now, a new study is connecting the dots on microplastics' mysterious correlation with heart attack and stroke risk.

"There is some microplastics in normal, healthy arteries," Dr. Ross Clark, a University of New Mexico medical researcher who led the study, told Business Insider before he presented his findings at the meeting of the American Heart Association in Baltimore on Tuesday.

"But the amount that's there when they become diseased — and become diseased with symptoms — is really, really different," Clark said.

Clark and his team measured microplastics and nanoplastics in the dangerous, fatty plaque that can build up in arteries, block blood flow, and cause strokes or heart attacks.

Compared to the walls of healthy plaque-free arteries, plaque buildup had 16 times more plastic — just in the people who didn't have symptoms. In people who had experienced stroke, mini-stroke, or vision loss, the plaque had 51 times more plastic.

"Wow and not good," Jaime Ross, a neuroscientist at the University of Rhode Island who was not involved in the study but has studied microplastics in mice, told BI after reading the results.

"It's very shocking to see 51 times higher," she said, adding that in her research, a signal that's just three times stronger is "very robust and striking."

What exactly the plastics are doing in there, if anything, remains a mystery. The new study offers some possible clues, though.

This research has not yet undergone the scrutiny of peer review, but Clark said he plans to submit it for publication in a peer-reviewed scientific journal later this year, after replicating some of their results.

Genetic activity looked different with plastic

Clark is a vascular surgeon, not a microplastics specialist. However, he got the idea for this study by talking with his colleague Matthew Campen, who recently discovered that human brains contain a spoon's worth of plastic.

Microplastics get way smaller than this.Getty Images

"We realized together that there really wasn't a lot of data on nanoplastics and microplastics in the vascular system, within blood vessels," Clark said.

Previous research had found that people with microplastics in their arterial plaque were more likely to have a heart attack or stroke or die.

To investigate why, Clark studied samples from 48 people's carotid arteries — the pair of superhighways in your neck that channel blood to your brain.

Tiny plastics in carotid plaque tied to elevated risk for heart attack, stroke, death

It is your doctor's and hospital's responsibility to contact stroke leadership and get research done to alleviate this problem. But I guess that is impossible since there is NO STROKE LEADERSHIP! So you're screwed.

Tiny plastics in carotid plaque tied to elevated risk for heart attack, stroke, death

Key takeaways:

• Patients who had microplastics or nanoplastics in their carotid plaque were more likely to die or have a heart attack or stroke than those who did not.
• The findings confirm prior in vitro and animal studies.

Perspective from Larry B. Goldstein, MD, FAAN, FANA, FAHA

Among patients with asymptomatic carotid artery disease who had carotid endarterectomy, those whose atheromas contained microplastics and/or nanoplastics had worse outcomes than those whose atheromas did not, researchers reported.

Risk for heart attack, stroke or all-cause death at nearly 3 years was more than fourfold higher in patients with carotid atheromas containing microplastics and/or nanoplastics (MNPs) than in those with no evidence of MNPs, the researchers wrote in The New England Journal of Medicine.

Data were derived from Marfella R, et al. N Engl J Med. 2024;doi:10.1056/NEJMoa2309822.

“Recent studies performed in preclinical models have led to the suggestion of MNPs as a new risk factor for cardiovascular diseases,” Raffaele Marfella, MD, PhD, from the department of advanced medical and surgical sciences at the University of Campania “Luigi Vanvitelli,” Naples, Italy, and colleagues wrote. “However, the clinical relevance of these findings is unknown. Evidence is lacking to show that MNPs infiltrate vascular lesions in humans or to support an association between the burden of MNPs and cardiovascular disease. To explore whether MNPs are detectable within atherosclerotic plaque and whether the burden of MNPs is associated with cardiovascular disease, we assessed the presence of these substances in surgically excised carotid artery plaque by means of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis and electronic microscopy. We then determined whether the presence of MNPs was associated with a composite endpoint of myocardial infarction, stroke or death from any cause.”

The researchers enrolled 304 patients with asymptomatic carotid artery disease undergoing carotid endarterectomy, of whom 257 completed follow-up of a mean of 33.7 months.

Marfella and colleagues detected polyethylene in the atheromas of 58.4% of patients (mean level, 21.7 g/mg of plaque) and found that 12.1% of those patients also had measurable amounts of polyvinyl chloride in their atheromas (mean level, 5.2 g/mg of plaque). In those with MNPs, the mean age was 71 years and 77.3% were men. In those without MNPs, the mean age was 73 years and 73.8% were men.

Electron microscopy showed “visible, jagged-edged foreign particles” in plaque macrophages and scattered in external debris, and X-rays revealed that some of these particles also contained chlorine, the researchers wrote.

Compared with those who had no MNPs detected, patients who had MNPs detected were at more than fourfold risk for 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, might accumulate in sites of atherosclerosis,” the researchers wrote. “Indeed, the large majority of particles detected in the current study were also below the 200 nm threshold suggested for gut and other barriers and were visible in the extracellular space as scattered debris, which aligns with the notion that the absorption and distribution of MNPs increase as particle size decreases.”

Perspective

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Larry B. Goldstein, MD, FAAN, FANA, FAHA

This is an important initial study showing an association between MNPs and cardiovascular outcomes. The primary finding is that patients with evidence of MNPs within atherosclerotic carotid artery plaques in asymptomatic persons were at higher risk of subsequent CV events. As pointed out by the authors, this does not necessarily mean that the two are causally linked because of the possibility of other unmeasured factors that could differ between those with and without MNPs. Preclinical data, however, provide some evidence of vascular effects of MNPs.

At this point, it is unclear what we can do to prevent events related to MNPs. MNPs are fairly ubiquitous. Because there appeared to be a relationship between the amount of MNPs and vascular events, developing strategies to reduce exposure on a population level may need to be considered.

This study was limited to patients who were treated for asymptomatic carotid artery atherosclerotic disease. Extending the observation to other populations would further support the association.

Larry B. Goldstein, MD, FAAN, FANA, FAHA

Healio | Cardiology Today Editorial Board Member

Ruth L. Works Professor and Chair, Department of Neurology

Associate Dean for Clinical Research, College of Medicine

Co-Director, Kentucky Neuroscience Institute

Co-Director, UK Neuroscience Research Priority Area

Interim Director, UK-Norton Stroke Care Network

KY Clinic - University of Kentucky

Disclosures: Goldstein reports no relevant financial disclosures.

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Source:

Marfella R, et al. N Engl J Med. 2024;doi:10.1056/NEJMoa2309822.