Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.
Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.
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微塑料和纳米塑料在动脉粥样硬化和心血管事件中的作用。
DOI：
10.1056/nejmoa2309822
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发表时间：
2024-03
期刊：
影响因子：
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通讯作者：
Raffaele Marfella;F. Prattichizzo;C. Sardu;Gianluca Fulgenzi;Laura Graciotti;Tatiana Spadoni;N. D’Onofrio;L. Scisciola;Rosalba La Grotta;Chiara Frigé;Valeria Pellegrini;Maurizio Municinò;M. Siniscalchi;Fabio Spinetti;Gennaro Vigliotti;C. Vecchione;A. Carrizzo;G. Accarino;Antonio Squillante;G. Spaziano;D. Mirra;Renata Esposito;Simona Altieri;Giovanni Falco;A. Fenti;Simona Galoppo;S. Canzano;F. C. Sasso;Giulia Matacchione;Fabiola Olivieri;F. Ferraraccio;I. Panarese;P. Paolisso;Emanuele Barbato;Carmine Lubritto;M. Balestrieri;C. Mauro;Augusto E Caballero;Sanjay Rajagopalan;Antonio Ceriello;Bruno D'Agostino;P. Iovino;Giuseppe Paolisso
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文献类型：
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作者：
Raffaele Marfella;F. Prattichizzo;C. Sardu;Gianluca Fulgenzi;Laura Graciotti;Tatiana Spadoni;N. D’Onofrio;L. Scisciola;Rosalba La Grotta;Chiara Frigé;Valeria Pellegrini;Maurizio Municinò;M. Siniscalchi;Fabio Spinetti;Gennaro Vigliotti;C. Vecchione;A. Carrizzo;G. Accarino;Antonio Squillante;G. Spaziano;D. Mirra;Renata Esposito;Simona Altieri;Giovanni Falco;A. Fenti;Simona Galoppo;S. Canzano;F. C. Sasso;Giulia Matacchione;Fabiola Olivieri;F. Ferraraccio;I. Panarese;P. Paolisso;Emanuele Barbato;Carmine Lubritto;M. Balestrieri;C. Mauro;Augusto E Caballero;Sanjay Rajagopalan;Antonio Ceriello;Bruno D'Agostino;P. Iovino;Giuseppe Paolisso
BACKGROUND Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking. 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.).
