Microplastics: A Modifiable Cardiac Risk Factor

Globally, cardiovascular disease is the most prevalent cause of death, and there are other risk factors involved that are not captured through traditional means. We present a review of the literature on microplastic exposure and discuss the clinical implications of microplastics for cardiovascular disease. Experimental studies show that micro- and nanoplastics induce oxidative stress, mitochondrial dysfunction, endothelial dysfunction, inflammation, thrombosis, dyslipidemia, and direct cardiotoxicity. These microplastics and nanoplastics have been identified in coronary plaque. Emerging clinical data have recently reported evidence in patients having microplastics in carotid plaques that are at a 4.5-fold increased risk of myocardial infarction, stroke, or death, in a cohort from the New England Journal of Medicine in 2024. Microplastics remain a potential modifiable risk for cardiovascular disease.