Patients who suffer major heart attacks are significantly more likely to have microplastics and nanoplastics circulating in the blood flowing through their coronary arteries than other cardiac patients, according to new research that is intensifying scrutiny of synthetic textiles as a source of environmental plastic exposure.
The study, published in the European Heart Journal and led by Professor Emanuele Barbato of Sapienza University of Rome’s Sant’Andrea University Hospital, analysed coronary blood samples from patients undergoing angiography. Researchers detected microplastics and nanoplastics in 84% of patients with ST-elevation myocardial infarction, the most severe and acute type of heart attack, compared with 40% of patients with chronic coronary syndromes and 32% of those with normal, healthy arteries.
Polyethylene, a plastic widely used in packaging and consumer goods, was the polymer identified most frequently in the samples, the researchers said. The study builds on a 2024 investigation by some of the same researchers, involving more than 300 patients, which found that microplastics embedded in arterial plaque were associated with a higher risk of heart attack, stroke or death from any cause in the years that followed.
The new research, a collaboration between Sapienza University, the University of Verona and the Research Centre on Environmental Pollution and Cardiovascular Diseases at the University of Campania “Luigi Vanvitelli” in Naples, also found that lifestyle and environmental exposures sharply raised the odds of plastic particles turning up in patients’ blood. Smokers were six times more likely than non-smokers to have detectable microplastics, and patients exposed to higher long-term levels of fine particulate air pollution also showed elevated rates. Among patients who both smoked and lived with high pollution exposure, every single one had detectable plastics in their blood, versus roughly one in eight among those with neither risk factor.
Barbato cautioned that the findings establish an association rather than proof of causation. “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,” he said. Co-author Professor Paolo Paolisso said little had previously been known about whether plastic particles reach the coronary circulation at all, or whether common environmental exposures such as smoking and air pollution influence their presence in the bloodstream, making the new dataset an early but notable piece of clinical evidence.
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Trade publication Ecotextile News said the findings raise fresh questions for synthetic textile supply chains and workplace exposure, given that polyester, nylon and other synthetic fibres are among the most persistent sources of microplastic shedding into water, air and household dust. Independent research has shown that a single wash load of synthetic garments can release between 6 million and 18 million microfibres, while everyday wear sheds additional particles directly into indoor air. Fabric structure, fibre density and finishing treatments all influence shedding rates, researchers studying textile microplastics have found, meaning manufacturing choices made long before a garment reaches a consumer can shape how much material it ultimately sheds over its lifetime.
Scientists say the likely biological mechanism involves chronic inflammation and oxidative stress triggered by plastic particles lodging in blood vessel walls, which can accelerate atherosclerosis and destabilise arterial plaque. Chemical additives that leach from plastic surfaces, including plasticisers and other pollutants, may compound the effect by disrupting lipid metabolism, researchers said.
Cardiovascular disease remains the leading cause of death worldwide, and researchers argue that even modest increases in risk linked to plastic exposure could carry significant public health consequences given how widespread microplastic contamination has become. The findings add to mounting pressure on policymakers negotiating a global plastics treaty, as well as on textile manufacturers facing calls to reduce microfibre shedding through fabric design, washing machine filtration standards and recycled-content mandates.
Researchers involved in the study called for larger, standardised studies to confirm causation, identify which polymer types carry the greatest risk, and clarify dose-response thresholds. Until then, they said, precautionary measures such as microfibre filters and reduced reliance on synthetic textiles remain reasonable steps for reducing exposure while the scientific picture sharpens.