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Patients who suffer heart attack have more micro and nanoplastic in their blood
· Researchers measured levels of plastic in the blood supplying the heart.
· Levels were highest in heart attack patients, compared to other patients.
· Smokers and people exposed to polluted air also had higher levels.
People who have suffered a serious heart attack had higher levels of micro and nanoplastics in their blood, compared to patients diagnosed with chronic ischemic heart disease and those who have normal blood vessels supplying the heart, according to a study published in the European Heart Journal [1] today (Wednesday).
The study also revealed that people who smoke and people exposed to higher levels of air pollution had higher levels of micro and nanoplastics in their blood.
The researchers say the study adds to growing evidence that environmental pollution may affect cardiovascular health.
This study is a collaboration between researchers at Sapienza University of Rome, University of Verona and the Research Centre on Environmental Pollution and Cardiovascular Diseases at the University of Campania “Luigi Vanvitelli” in Naples, Italy, a centre dedicated to understanding how environmental pollutants influence cardiovascular health.
The first author of the study Dr Pasquale Paolisso from Sant'Andrea Hospital Sapienza University of Rome, Italy, said: “Micro and nanoplastics are tiny plastic particles that are found virtually everywhere in the environment, including the air we breathe, the water we drink, and many foods we consume. In recent years, scientists have begun to detect these particles in human tissues and organs, raising concerns about their potential health effects.
“However, very little was known about whether these particles are present in the coronary circulation – the blood flowing through the arteries that supply the heart – or whether environmental exposures such as smoking and air pollution might influence their presence.”
The study included 61 patients at Sant’Andrea University Hospital or Azienda Ospedaliera Universitaria Integrata of Verona, Italy diagnosed with either a heart attack, chronic ischemic heart disease or normal coronary arteries.
Researchers took samples of the patients’ blood from the blood vessels supplying the heart and from elsewhere in the body. They also collected data on whether the patients were smokers and their exposure to pollution, both on the day of testing and over the preceding two years.
Coronary micro and nanoplastics were analysed at the Research Centre for Environmental Pollution and Cardiovascular Diseases, University of Campania Luigi Vanvitelli', Naples, Italy.
Among those who had heart attacks, micro and nanoplastics were detected in 84% of patients, compared with 40% of patients with chronic ischemic heart disease and 32% of patients with normal coronary arteries. Heart attack patients had a greater variety of plastic types in their blood. The most common type of plastic was polyethylene, which is commonly used in packaging and consumer products.
Patients exposed to higher long-term levels of air pollution (PM2.5/particles measuring 2.5 μm or less in diameter) were more likely to have microplastics in their blood, and smokers were six times more likely to have microplastics in their blood. All patients who were smokers and were exposed to higher air pollution levels had plastics in their blood, compared with only 12.5% of patients who did not smoke and were not exposed to higher levels of air pollution.
The research was led by Professor Emanuele Barbato from Sapienza University of Rome and Director of the Cardiology Unit of Sant'Andrea University Hospital, Rome, Italy. He said: “These findings do not prove that microplastics cause heart attacks, but they reveal a strong association between environmental exposures, microplastics in the blood and cardiovascular disease.
“In our study, smoking history was strongly linked to microplastics in the blood. Our findings suggest that smoking might make it easier for micro and nanoplastics to enter the blood stream via the lungs. Air pollution may act in a similar way.
“The results highlight the need to consider microplastic pollution as part of the broader environmental determinants of health. Policies that reduce air pollution, tobacco exposure and environmental plastic contamination could have benefits that extend beyond environmental protection and potentially improve cardiovascular health.”
In an accompanying editorial [2] Professor Andreas Daiber from University Medical Centre of the Johannes Gutenberg University, Mainz, Germany and colleagues said: “Over time, plastics fragment into microplastics (<5 mm) and nanoplastics (<1 μm), which are now detected in virtually all environmental compartments, including air, water, and soil. Increasingly, these particles are also found within the human body, including blood, lung tissue, placenta, and breast milk, indicating systemic exposure.
"Until recently, the cardiovascular effects of plastic exposure were largely speculative. However, emerging clinical evidence now suggests a potential link between NMPs and cardiovascular disease. In patients undergoing carotid endarterectomy, NMPs were detected within atherosclerotic plaques, and their presence was associated with an increased risk of myocardial infarction, stroke, and all-cause mortality. In their study published in this issue of the European Heart Journal, Paolisso et al. investigated 61 patients undergoing coronary angiography for suspected coronary artery disease. Patients were categorized into ST-segment elevation myocardial infarction (STEMI), chronic coronary syndromes (CCS), and controls. Using advanced analytical methods, NMPs were detected in both peripheral and coronary blood. Notably, plastic particle concentrations were highest in STEMI patients, intermediate in those with CCS, and lowest in controls. These findings were accompanied by elevated inflammatory markers, including tumour necrosis factor-α and interleukin-6, suggesting a link between plastic exposure and systemic inflammation. Although limited by sample size, these findings represent early clinical evidence that plastic particles may be associated with acute cardiovascular events.
“NMPs represent a rapidly emerging environmental exposure with potentially important implications for cardiovascular health. Early clinical evidence demonstrates that plastic particles can enter the circulation and accumulate in vascular tissues, while experimental studies indicate that they trigger key mechanisms of vascular injury, including oxidative stress, inflammation, and endothelial dysfunction. Although substantial uncertainties remain, the convergence of epidemiological, clinical, and mechanistic evidence suggests that plastic pollution may represent a previously underestimated cardiovascular risk factor. Addressing this challenge will require coordinated efforts across disciplines and policy domains. In the era of the Anthropocene, protecting cardiovascular health will increasingly depend on reducing not only traditional risk factors but also the growing burden of environmental pollutants (the detrimental part of the exposome), among which plastics may soon play a central role.”
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Professor Derek Chew is Chief Scientific and Medical Officer at the Heart Foundation
"The Heart Foundation examined existing evidence about the impact of microplastics on cardiovascular health as part of its submission into the recent Australian Government Senate Inquiry into the impact of microplastics and other toxics on human health.
While the evidence to date does not yet support micro and nano plastics as a cause of cardiovascular disease, strong links continue to emerge.
Several studies have shown that microplastics gather in human tissues, including cardiovascular tissue, over time.
Among the emerging health evidence is that micro- and nano plastics have been found in cardiovascular tissues, including atherosclerotic plaques, which are the main case of heart attack, stroke and sudden cardiac death.
We cannot avoid being exposed to them because they live in our environment and they are in the air we breathe, the food we eat, the water we drink, and the clothes we wear.
It is entirely plausible that once these particles are present in the human body, they may increase the risk of cardiovascular disease over time if left undetected.
We need more research to understand if continued human exposure to micro- and nano plastics does in fact cause cardiovascular disease.
This is why it is so important for Australia to address both the environmental and health risks of micro and nano plastics with a national coordinated policy approach.
Reducing plastic use, waste and pollution not only benefit the environment it may also help protect the human heart.”
Professor Kevin Thomas is the Director of the Queensland Alliance for Environmental Health Sciences (QAEHS) at The University of Queensland
"The key question is whether the study detected plastics or whether it detected molecules that look like plastics. Microplastics are notoriously challenging to measure in human blood, and based on recently published confidence levels, the results presented are presumptive of the presence of plastics at best.
While the authors are to be commended for their efforts to control contamination, the study ignores findings that show that the pyrolysis gas chromatography mass spectrometry method used to quantify "nano- and microplastics (NMPs)" is not suitable for polyethylene and polyvinyl chloride, two of the main plastics detected.
It is just as plausible that endogenous lipids [fats] in the blood are being misidentified as plastics.
The headline could just as well read 'Patients who suffer heart attacks have more lipids in their blood’."
Professor Thava Palanisami is Team Leader of the Australian Plastics Research and Innovation Laboratory at the University of Newcastle
"This study provides important new evidence that micro- and nanoplastics can be detected in the coronary circulation of patients experiencing heart attacks and are associated with higher levels of inflammation and environmental exposures such as air pollution and smoking. While the findings do not prove that plastics directly cause heart attacks, they strengthen the growing scientific evidence that plastic pollution is an emerging public health issue deserving serious attention.
Although the authors implemented rigorous contamination controls, measuring micro- and nanoplastics in blood remains technically challenging. There is still no internationally standardised method for sampling, extraction, identification and quantification, making comparisons between studies difficult. In addition, current analytical methods cannot fully characterise the smallest nanoplastics (<1 µm), which may have different biological behaviour. Another limitation is that the study measured the presence of plastic polymers but did not distinguish whether the observed biological effects were caused by the particles themselves, the chemicals they carry, or co-exposure to other environmental pollutants such as air pollution and tobacco smoke. The finding that smoking was the only independent predictor of microplastic detection in multivariable analysis highlights the complexity of separating these environmental exposures.
The study highlights the need for larger, long-term human studies to determine whether reducing exposure to micro- and nanoplastics can lower the risk of cardiovascular disease. Given the widespread presence of plastics in our food, water and air, we need coordinated action to reduce unnecessary plastic pollution, improve human exposure monitoring, and accelerate research into the health impacts of plastics. Protecting people from plastic pollution should become a key component of future environmental and public health policy.
Overall, this study is an important step forward, but much larger prospective studies with harmonised analytical methods and detailed exposure assessment are needed before firm conclusions can be drawn about the causal role of micro- and nanoplastics in cardiovascular disease."
Dr Paul Harvey is an environmental scientist (pollution specialist) and science communicator. He is the owner of Environmental Science Solutions, and often engages with audiences under the name "Doc PJ Harvey"
"This study adds to an alarming body of evidence connecting micro- and nano-plastic exposure to adverse human health outcomes.
This is in contradiction to the current regulatory posture in Australia. As recently as April of 2026, the Australian Centre for Disease Control has actively discredited compelling evidence that points to adverse human health outcomes arising from exposure to microplastics [1].
Although this new research by Paolisso et al. is constrained by its study population size, it puts forward damning evidence linking plastic exposure to one of Australia’s leading causes of death – coronary artery disease (CAD).
More work certainly needs to be done to better understand the drivers behind CAD, but in light of this new evidence, the question must be asked: what precautionary steps is the government, through its various regulatory arms, taking to mitigate risks to human health, wildlife and the environment, that arise from plastic exposure?"
[1] https://www.cdc.gov.au/resources/publications/microplastics-and-health-report
Dr Julia Shanks, Senior Research Fellow in Physiology, University of Auckland
"The compounding effect of total environmental exposures across the life span is a well-known risk factor for developing cardiovascular disease (or heart disease). These compounding risks are also known to lead to the development of cardiovascular disease at a younger age, contributing to increased heart disease-related deaths and reduced quality of life.
"We know that environmental exposures rarely occur in isolation. This study highlights the presence of micro- and nanoplastics in the blood that supplies the heart muscle itself, in individuals experiencing a heart attack. While it is noted that this study cannot definitively say that the micro-and nano-plastics were the cause of the heart attack, it is noteworthy that, in the modern world, we are increasingly finding micro- and nanoplastics in unexpected places.
"Studies of micro- and nanoplastics at the cellular and molecular levels have shown that they can disrupt normal cellular processes and affect blood vessel function. This study provides clinical evidence for the presence of micro-and nano-plastics at the exact site of cardiac dysfunction in individuals having a heart attack."
Jeroen Douwes, Professor of Public Health, Massey University
"This is an interesting, albeit small, study suggesting a role for micro and nano plastics (MNPs) in ischaemic heart disease. Despite the large increases in MNP exposure observed since it was first reported 20 years ago, few health studies have been conducted. However, evidence from in vitro and animal models show: inflammatory and other immune responses; oxidative stress; endocrine disruption; cyto-, geno-, and neuro-toxicity; metabolic effects; and gut-microbiota disruption. Emerging clinical studies show associations with cardiovascular disease, stroke, neurodegeneration, neurological symptoms, anxiety and depression. This suggests that MNPs may be a significant and emerging health risk, but research on MNPs and health is still in its infancy and more well-designed and larger studies in human populations are urgently needed.
"This study adds to the emerging evidence that MNP exposure may increase the risk of cardiovascular disease. Previous studies have been criticised for using methods that were not specifically designed to eliminate plastic contamination from sample collection and processing, which the current study addressed, adding to the importance of the study.
"The paper focuses on airborne MNP exposure, and only in passing refers to MNP exposure through diet, which is another significant exposure route that may be at least as important for cardiovascular risk.
"MNPs originate from items (packaging, car tyres, clothing, toys, household products, etc), or are manufactured for use as additives, e.g., to fertilisers, cleaning agents, and personal-care products, and have become ubiquitous in the environment. As a result, they can be detected in food, drinking water, and air, with exposure occurring through ingestion (e.g., via consumption of highly processed foods, reheated foods in plastic containers, bottled drinks, and teabags), inhalation (associated with synthetic clothing, floor coverings, car-tyre wear, and indoor dust), or skin absorption (via personal-care products and synthetic-fibre clothing). So, other exposure routes may be equally or likely more important.
"Due to their small size, MNPs have the potential to migrate through the body, including, as shown in recent studies, the gut, blood, airways, liver, kidney, cerebrospinal fluid, brain, placenta, breast milk, testicles, etc., so health effects will likely not be limited to the cardiovascular system.
"Of interest, in addition to synthetic, mostly oil-derived, polymers, MNPs may contain >16,000 chemical additives, including plasticisers, flame retardants, UV stabilisers, colourants, manganese, other heavy metals, etc, which can leach into surrounding tissue, thus further contributing to health risks, highlighting the need to study the potential health effects that may arise from this new environmental pollutant. This is urgently needed as MNP pollution is rapidly increasing, and currently estimated at 10-40 million tonnes per annum, with an expected doubling of emissions by 2040. If these exposures are, as emerging evidence suggests, causally associated with ill health then we need to start looking at safer options not involving plastics."
Emeritus Professor of Toxicology Ian Shaw, University of Canterbury
"Interest in the impact of microplastics on health is growing exponentially because our exposure via food, drinking water and air is increasing.
"This is an excellent, well thought out and conducted study. The number of patients in the study is small – I would regard it as a pilot study.
"Not only myocardial infarction (heart attack) patients showed microplastics in their coronary circulation. Control and other heart disease patients also showed microplastics, this indicates widespread exposure.
"Heart attack patients had significantly higher levels of microplastics than controls or other coronary disease patients. The fact that microplastics are present at higher levels in heart attack patients does not prove that they are the root cause of the disease. It might be that exposure to something else is associated with microplastics, but the ‘something else’ has not been measured in the study.
"Microplastics are likely to initiate an inflammatory response, as evidenced by raised biochemical inflammation markers in the study. This presents a credible mechanism for a link between microplastics and heart disease.
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