Effect of CRP, IL-6, Leukocytes, NLR on Chronic Periodontitis in Acute Coronary Syndrome

Abstract

Chronic periodontitis is associated with coronary heart disease (CHD), including Acute Coronary Syndrome (ACS), which causes inflammation. CRP, IL-6, leukocytes, neutrophils, and lymphocytes are inflammatory mediators. This study aimed to evaluate CRP, IL6, leukocytes, and NLR effect on chronic periodontitis in ACS patients. A total of 60 ACS patients who underwent coronary angiography were used in this study. Coronary artery assessment was measured based on QCA coronary angiography. Periodontal status measured were Oral Hygiene Index (OHI-S), Bleeding on Probing (BOP), and Periodontal Index (PI). The normal-mild limit values of chronic periodontitis were periodontal depth (PD) <4mm, while the moderate-severe of chronic periodontitis was PD ≥ 4 mm. Correlation of CRP, IL-6, leukocytes, and NLR to chronic periodontitis was determined by the Spearman correlation test, followed by path analysis using smartPLS software version 3.0. Additionally, the Goodness of Fit analysis and logistic regression was also conducted. Moderate-severe and normal-mild of chronic periodontitis were found in 45 patients (75%) and 15 patients (25%), respectively. OHI-S, BOP, and PI in moderate-severe chronic periodontitis were significantly higher than in the normal-mild chronic periodontitis group (p<0.05). A comparison of CRP, IL-6, leukocytes and NLR showed no significant value (p>0.05) in both groups. There was no significant positive relationship between CRP, IL-6, leukocytes, and NLR with chronic periodontitis. No direct effect of CRP, IL-6, leukocytes and NLR on chronic periodontitis was found, but female sex and smoking directly affected chronic periodontitis (p<0.05). Female and smoking patients had a higher risk of developing more severe chronic periodontitis with a female OR value of 6.916 (95% CI: 0.470 – 101.798), while the OR smoking was 10.759(95% CI: 1.064 – 108.762). ACS patients were dominated by moderate to severe chronic periodontitis and had worse OHI-S, BOP, and PI. There were no significant effects of CRP, IL-6, leukocytes, and NLR on chronic periodontitis. Our findings revealed a significant direct effect and a high risk of female sex and smoking against chronic periodontitis on ACS patients.

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“…Due to the high reactivity of ROS molecules, cells can generate scavenger molecules and antioxidants that maintain redox homeostasis by upregulating genes involved in oxidative stress reduction. ROS molecules induce the expression of proinflammatory proteins by activating various transcription factors, including NF-κB [6]. Following HBO exposure, ROS molecules modify adaptive mechanisms that mitigate cell damage [3].…”

“…MMP-12 also activates interferon-alpha (IFN-α), which contributes to the repair of endothelial dysfunction. In addition, MMP-12 can promote anti-inflammatory signals and suppress proinflammatory signals [6]. Previous research has identified potential protein targets for MMP-12, allowing it to exert its proteolytic activity on various protein substrates.…”