"The inflammation link between periodontal disease and coronary atherosclerosis in patients with acute coronary syndromes - case-control study".

Abstract

Background Coronary atherosclerosis and periodontal disease, due to their prevalence, are a serious epidemiological problem. Pathophysiological evidence points to their possible common inflammatory etiopathological background. The aim of the study was to analyze the relationship between the presence and severity of periodontitis, systemic inflammation and selected parameters of myocardial injury and heart function in patients with acute myocardial infarction. Methods The study group consisted of 71 patients 54.22(7.05) - year - old hospitalized due to acute myocardial infarction. The patients underwent a coronary angiographic examination and echocardiography. The following laboratory parameters were determined: blood morphology, hsCRP, ESR, fibrinogen, troponin I, CK-MB, BNP, lipidogram, glucose, creatinine, GFR, TSH, HbA1c. Dental assessment of the patients was performed and the following indicators were included: the number of teeth preserved, approximal plaque index (API), bleeding on probing (BoP), pocket depth (PD), the number of bleeding periodontal pockets ≥ 4 mm in depth (NoPD≥4 mm), the percentage of bleeding periodontal pockets ≥ 4 mm in depth (%PD≥4 mm), clinical attachment loss (CAL). The control consisted of 40 patients 52 (± 8.43)- year-old without a history of coronary heart disease. These patients were subjected to a periodontal examination using the above parameters and classification methods. Results The BI (bleeding index) significantly correlated with fibrynogen. All indices regarding the pocket depth (PD, NoPD≥4mm,% PD4≥mm) correlated significantly with the number of leukocytes. PD and NoPD≥4mm were also associated significantly with the level of hsCRP. The BI is correlated closely with the levels of BNP. The multifactorial analysis showed that significant predictors of myocardial infarction are API and BI. The analysis showed that API and BI are important predictors of troponin levels. Linear regression analysis showed that only CAL is a significant predictor of BNP. Conclusions Patients with acute myocardial infarction have worse periodontal status compared to people without coronary heart disease. Higher severity of periodontal disease, poorer oral hygiene and increased activity of the periodontitis leads to greater manifestation of systemic inflammation in patients with acute myocardial infarction. Periodontitis is a risk factor for myocardial infarction and also affects the degree of post-infarction left ventricular damage, which means that there is an inflammatory link between these two diseases.