Microplastics and nanoplastics (MNPs) have implicated in cardiovascular disease in preclinical studies. Our objective is to investigate the relationship between MNPs in the coronary arteries and major adverse cardiac events (MACE) in patients with myocardial infarction (MI).We conducted a prospective observational study involving patients undergoing coronary angiography for MI. Coronary blood samples were analyzed for the presence of MNPs using pyrolysis-gas chromatography-mass spectrometry. A total of 142 patients were enrolled, with 110 completing a 31.5-month follow-up. Among them, 48 (43.6 %) had detectable polystyrene, 79 (71.8 %) had polyethylene, 105 (95.4 %) had polyvinyl chloride (PVC), and 68 (61.8 %) had polyamide 66 in their coronary blood. PVC concentration was higher in patients who experienced MACE. Furthermore, PVC levels were positively associated with proinflammatory factors (IL-1β, IL-6, IL-18, and TNF-α), and associated with higher odds of MACE (OR: 1.090, 95 %CI: 1.032-1.1523, P = 0.002). Notably, for each 10-unit increase in PVC, there was a 1.374-fold increase in the risk of MACE (OR=2.374, 95 %CI: 1.366-4.128, P = 0.002). Additionally, we collected blood and thrombus samples from an additional 21 MI patients, finding that PVC levels in coronary thrombi were positively correlated with inflammatory markers and monocyte/macrophage infiltration.
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