Severe and moderate periodontitis are associated with acute myocardial infarction

Abstract

Background: An association between periodontitis and cardiovascular disease is now well documented; however, the effect of periodontitis severity levels on this outcome, specifically on acute myocardial infarction (AMI), remains unexplored. This study investigated the association between levels of periodontitis severity (exposure) and AMI (outcome). Methods: This case-control study, matched by sex and age, was conducted with 621 participants, with 207 individuals treated in the emergency department of Santa Izabel and Ana Nery Hospitals in Salvador, Bahia, Brazil, diagnosed with a first AMI event, and compared to 414 individuals without a diagnosis of AMI. Levels of periodontitis severity followed two criteria: (1) Center for Disease Prevention and Control and American Academy of Periodontology; (2) Gomes-Filho et al. (2018) using criteria that also evaluated bleeding upon probing. Conditional logistic regression analysis was performed and odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained. Results: The adjusted association measurements showed a positive association between both severe (OR adjusted ranged from 2.21 to 3.92; 95% CI ranged from 1.03 to 10.05) and moderate periodontitis (OR adjusted ranged from 1.96 to 2.51; 95% CI ranged from 1.02 to 6.19), and AMI, for both periodontitis diagnostic criteria. It demonstrated that among those with moderate and severe periodontitis, the chance of 1444

Is Periodontitis a Risk Predictor with Adverse Outcomes for Cardiovascular Diseases: Treat Gums, Save Heart

“…After adjustments for relevant confounders, this association did, however, remain more among females 9 , and thus underlining the importance of considering poor dental health when evaluating cardiovascular risk, especially in younger females, the pronounced association among younger females deserves attention. In patients with moderate and severe periodontitis, the chance of having AMI was approximately two to four times higher than among those without periodontitis 8 . However, the chance of having AMI was higher among those individuals with severe periodontitis than with moderate periodontitis demonstrating a possible relationship among the levels of periodontitis severity on AMI.…”

“…Periodontitis can predispose to myocardial infarction as a result of a number of possible biological mechanisms that is responsible for the increased inflammatory response in atheromatous lesions. Various mechanisms include high hemostatic and thrombotic markers that promote a prothrombotic and inflammation status; dyslipidemia promotion with a consequent increase in proinflammatory lipid classes and subclasses; increased systemic levels of inflammatory mediators stimulated by bacteria or their products in distant sites of the oral cavity, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma; and common genetic factors present in both diseases leading to increased inflammatory responses 8 . Studies have proved association between moderate and severe periodontitis severity levels and AMI, after adjustment of following confounders: schooling level, current smoking habit, hypercholesterolemia, and BMI.…”

“…The results that more severe periodontitis has a higher strength of association than moderate periodontitis in relation to myocardial infarction lead to argue for provision of dental care for individuals with more severe levels of periodontitis, as these conditions are more related to myocardial infarction 8 .…”

Impact of Periodontitis on Cardiovascular Diseases

“…PERIODONTITIS AND CAD/CHD Dietrich and group, in a systemic review, found a robust association between PD and CAD/CHD [18]. Patients with PD have a higher rate of coronary artery events [75] and those with severe PD have the highest risk [76]. They also exhibit increased CHD mortality [77].…”

The relationship between periodontal status and rheumatoid arthritis – systematic review

“…Many studies of both PD and RA showed increased risk of hypertensive heart disease, ischemic heart disease, stroke, atrial fibrillation or flutter and myocardial infarction [ 33 ]. In patients with moderate and severe PD the risk of myocardial infarction was even two to four times higher [ 34 ].…”