The traditional narrative of heart attacks, which indicates plaque buildup driven by high cholesterol, poor diet, smoking, hypertension as the major culprit, may soon get a serious plot twist. A pioneering study, conducted by researchers in Finland and the UK and published in the Journal of the American Heart Association, presents compelling evidence that heart attacks may, in fact, sometimes be infectious. Here's the gist: arterial plaques, those cholesterol-laden bulges in blood vessels, can quietly harbour bacterial biofilms, gelatinous structures in which bacteria live shielded from the body's immune system and antibiotics. These biofilms may lurk for decades, often undetected. But when a viral infection, or perhaps another external stressor, occurs, it can "wake up" the bacteria. The resulting inflammation may then rupture the fibrous cap of the plaque, leading to a fatal blood clot or myocardial infarction (heart attack).
The study's lead, Professor Pekka Karhunen, explains that although microbial involvement in atherosclerosis has been hypothesized before, this is one of the most direct, convincing pieces of evidence to date. The team identified bacterial DNA from oral microbes within atherosclerotic plaques, and used a tailored antibody to detect actual biofilm structures in arterial tissue. In patients who suffered heart attacks, bacterial release from these biofilms corresponded with local inflammation and plaque rupture.
This discovery doesn't negate traditional risk factors, but it does add a new layer. If infections can trigger heart attacks via biofilm activation, this opens exciting new avenues: diagnostics that check for these biofilms, targeted therapies, or even vaccines aimed at preventing bacterial activation within plaques.
Deep Dive: What It Means for Indian Patients
India faces an immense and growing burden of heart disease, often striking individuals at a relatively young age. While lifestyle factors remain pivotal, this new evidence suggests that infection control, especially for viral illnesses, may also be a silent guardian against heart attacks.
Our health systems often emphasize cholesterol, blood pressure, and diabetes management, but vaccination, early treatment of infections, and perhaps even future anti-biofilm interventions could become crucial tools in the cardiovascular prevention toolkit.
Study Caveats And Relevance
However, before becoming too hopeful about this study's implications, it is very important to note the following caveats:
- Population sample: The study primarily analyzed post-mortem and surgical samples from patients in Europe. Whether these biofilm-driven heart attacks occur similarly in Indian populations remains unknown.
- Cause vs. correlation: While bacterial DNA and biofilms were detected in plaques, and activation was temporally linked with inflammation, more longitudinal and interventional research is needed to establish causation.
- Infection types: The triggers, viral or otherwise, that awaken biofilms haven't been fully mapped. Common infections like flu, COVID-19, or bacterial illnesses may all potentially play a role.
Thus, while findings are tantalizing, their direct applicability to everyday clinical practice, especially in resource-constrained settings like much of India, is not yet established.
Take all infections and their treatment seriously to avoid complications later
Photo Credit: Pexels
Practical Implications For Patients
And yet, the findings of the study do highlight some healthcare factors and features that every Indian should keep in mind for overall well-being and heart health.
- Stay updated with vaccinations, because flu and COVID shots not only reduce infection but may indirectly protect heart health. Evidence from Harvard Health links flu to a sixfold increase in heart attack risk within the week after infection
- Promptly treat infections, especially respiratory or oral. Keep your vaccinations, dental health, and general immunity in check.
- Stick with conventional prevention methods for heart attacks and especially control hypertension, diabetes, cholesterol, maintain healthy weight, and remain active.
- Watch for future innovations, but with caution. As this research evolves, we may see anti-biofilm treatments or vaccines, but those are likely years away.
This emerging research underscores an exciting, if early, expansion in our understanding of cardiac events: beyond lifestyle and cholesterol, microbial triggers may be silently fanning the flames. For Indian readers, the takeaways are practical: stay updated on vaccines, treat infections quickly, and follow established heart-healthy habits, because your heart may be more connected to infection than you ever imagined.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
Karhunen P J, et al. Viridans Streptococcal Biofilm Evades Immune Detection and Contributes to Inflammation and Rupture of Atherosclerotic Plaques, Journal of the American Heart Association (2025).
More evidence links flu infection to heart attack risk, Harvard Health (Oct 2024): influenza linked to a six-fold increase in heart attack risk in the week following diagnosis.
