Myocardial infarction may be an infectious disease

Title, Framing, and Scope

• Many see the original “may be an infectious disease” title as clickbait or overstated.
• Commenters argue it’s more accurate to say some myocardial infarctions may be triggered or contributed to by infection, not that MI as a whole is an infectious disease.
• Others counter that hidden bacterial biofilms rupturing and causing thrombosis does fit a lay notion of “infection,” but still only for a subset of cases.

What the Study Actually Shows

• Study examined atherosclerotic tissue from people with heart disease and found oral viridans streptococci DNA in ~40% of plaques.
• Using custom antibodies and staining, they saw biofilm-like bacterial colonies in lipid cores and plaque walls, poorly recognized by innate immunity.
• Hypothesized mechanism: systemic infection → immune activation → biofilm disruption → plaque rupture → thrombus → MI.

Correlation, Causation, and Missing Baselines

• Several commenters emphasize that this is correlation in a highly selected group (all with heart disease) and there is no baseline for how common these bacterial signatures are in the general population.
• Concerns are raised about jumping to antibiotics or vaccines before showing that these bacteria are truly causal and not just bystanders.
• Comparisons are made to “fire trucks at house fires” as a caution against misreading association as cause.

Infections as Triggers vs Primary Causes

• Thread largely converges on: this is “another way it can happen,” not a replacement for known pathways (atherosclerosis, genetics, congenital defects, hypertrophy from bodybuilding, etc.).
• Flu and other acute infections are already known to transiently raise MI risk via inflammation and lowered oxygen supply; COVID is mentioned as another example of acute infection with long-term cardiovascular impact.
• Long debate around HPV and cervical cancer illustrates how tricky it is to quantify what fraction of a disease is truly infection-driven.

Oral Health, Mouthwash, Antibiotics, Phages

• Poor oral health has long been linked to cardiovascular risk; this study strengthens a specific mechanistic link.
• Some speculate about antibiotics courses or antiseptic mouthwash as interventions; others warn these can disrupt beneficial microbiota and drive resistance.
• Phage therapy and anti-biofilm agents are mentioned as theoretically promising but technically and clinically challenging.

Risk Factors and Testing

• One detailed subthread lists “modern” risk markers (hs-CRP, ApoB, Lp(a), HbA1c, eGFR) and promotes comprehensive blood panels.
• Others push back on commercial plugs, note that traditional lipids (LDL, HDL, triglycerides) still matter, and discuss practical barriers to ordering advanced tests in different health systems.