Unmasking the haemostatic potential of quotidian plastics: upon first glance

Acrylamide, bisphenols, phthalates, and micro- and nanoplastics are pervasive environmental pollutants with well-documented carcinogenic, neurotoxic, and reproductive effects. Nonetheless, their potential contribution to cardiovascular diseases remains strikingly unrecognised, despite the rising incidence of their clinical manifestations in younger populations and growing evidence of their effects on haemostasis and thrombosis. Single- and dual-antiplatelet therapy only partially controls the prothrombotic phenotype driven by thromboinflammation, whilst the role of plastics as platelet aggregation enhancers remains an under-addressed gap in current cardiovascular disease prevention strategies. This mini-review synthesises 11 years of ex vivo human and in vivo rodent evidence on the haemostatic effects of plastics, with attention to platelet aggregation, blood coagulation parameters, and their possible mechanisms. Bisphenols dominate the available literature, skewing the evidence towards their haemostatic effects relative to findings on acrylamide and phthalates. Regarding micro- and nanoplastics, most evidence has come from microplastics, owing to analytical challenges in quantifying nanoplastics. Because exposure to plastics and their complex chemical mixtures remains largely unregulated, the collated evidence on their cardiovascular effects should prompt regulatory action. Our review also highlights the research gaps to be prioritised in future toxicological approaches, as well as the need to integrate coagulation markers to establish dose-response thresholds of public health relevance.