Microplastics and Nanoplastics in Atheromas and Cardiovascular Events

被引：264

作者：

Marfella, Raffaele ^{[1
,2
,24
]}

Prattichizzo, Francesco ^{[11
]}

Sardu, Celestino ^{[1
,2
]}

Fulgenzi, Gianluca

Graciotti, Laura ^{[13
]}

Spadoni, Tatiana ^{[13
]}

D'Onofrio, Nunzia ^{[3
]}

Scisciola, Lucia ^{[1
,2
]}

La Grotta, Rosalba ^{[11
]}

Frige, Chiara ^{[11
]}

Pellegrini, Valeria ^{[11
]}

Municino, Maurizio ^{[6
]}

Siniscalchi, Mario ^{[7
]}

Spinetti, Fabio ^{[8
]}

Vigliotti, Gennaro

Vecchione, Carmine ^{[15
,16
]}

Carrizzo, Albino ^{[16
]}

Accarino, Giulio ^{[16
]}

Squillante, Antonio ^{[16
]}

Spaziano, Giuseppe ^{[17
]}

Mirra, Davida ^{[17
]}

Esposito, Renata ^{[17
]}

Altieri, Simona ^{[17
]}

Falco, Giovanni ^{[12
,17
]}

Fenti, Angelo ^{[4
]}

Galoppo, Simona ^{[4
,8
]}

Canzano, Silvana ^{[9
]}

Sasso, Ferdinando C. ^{[1
,2
]}

Matacchione, Giulia ^{[14
]}

Olivieri, Fabiola ^{[12
,14
]}

Ferraraccio, Franca ^{[5
]}

Panarese, Iacopo ^{[5
]}

Paolisso, Pasquale ^{[10
,20
]}

Barbato, Emanuele ^{[18
]}

Lubritto, Carmine ^{[17
]}

Balestrieri, Maria L. ^{[3
]}

Mauro, Ciro ^{[7
]}

Caballero, Augusto E. ^{[21
,22
]}

Rajagopalan, Sanjay ^{[23
]}

Ceriello, Antonio ^{[11
]}

D'Agostino, Bruno ^{[17
]}

Iovino, Pasquale ^{[17
]}

Paolisso, Giuseppe ^{[1
,2
,19
]}

机构：

[1] Univ Campania Luigi Vanvitelli, Dept Adv Med, Caserta, Italy

[2] Univ Campania Luigi Vanvitelli, Dept Surg Sci, Caserta, Italy

[3] Univ Campania Luigi Vanvitelli, Dept Precis Med, Caserta, Italy

[4] Univ Campania Luigi Vanvitelli, Dept Engn, Caserta, Italy

[5] Univ Campania Luigi Vanvitelli, Dept Mental Hlth & Publ Med, Sect Stat, Caserta, Italy

[6] Azienda Sanitaria Locale Napoli 2 Nord, Dept Forens Evaluat & Necroscop Med, Azienda Sanit Locale Napoli 2 Nord, Naples, Italy

[7] Hosp Cardarelli, Dept Cardiol, Naples, Italy

[8] Osped Mare Azienda Sanit Locale Napoli 1, Dept Vasc Surg, Naples, Italy

[9] Univ Campania Luigi Vanvitelli, Environm Technol, Caserta, Italy

[10] Univ Federico II, Dept Adv Biomed Sci, Naples, Italy

[11] IRCCS Multimed, Milan, Italy

[12] Polytech Univ Marche, Dept Clin & Mol Sci, Rome, Italy

[13] Polytech Univ Marche, Dept Excellence SBSP Biomed Sci & Publ Hlth, Rome, Italy

[14] IRCCS Ist Nazl Ricovero & Cura Anziani, Ancona, Italy

[15] IRCCS Neuromed, Vasc Physiopathol Unit, Pozzilli, Italy

[16] Univ Salerno, Dept Med Surg & Dent, Salerno, Italy

[17] Univ Campania Luigi Vanvitelli, Dept Environm Biol & Pharmaceut Sci & Technol, Caserta, Italy

[18] Sapienza Univ Rome, Dept Clin & Mol Med, Rome, Italy

[19] UniCAMILLUS Int Med Univ, Rome, Italy

[20] Onze Lieve Vrouw Hosp, Cardiovasc Ctr Aalst, Aalst, Belgium

[21] Harvard Med Sch, Boston, MA USA

[22] Brigham & Womens Hosp, Div Endocrinol Diabet & Hypertens, Boston, MA USA

[23] Case Western Reserve Sch Med, Univ Hosp, Cleveland, OH USA

[24] Univ Campania Luigi Vanvitelli, Surg Sci, Piazza Miraglia 2, I-80138 Naples, Italy

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2024年 / 390卷 / 10期

基金：

美国国家卫生研究院;

关键词：

CAROTID-ENDARTERECTOMY; MORTALITY; DISEASE;

D O I：

10.1056/NEJMoa2309822

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 mu g per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2 +/- 2.4 mu g 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.)

引用

页码：900 / 910

页数：11

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