Journal
METABOLISM-CLINICAL AND EXPERIMENTAL
Volume 60, Issue 1, Pages 127-133Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.metabol.2009.12.016
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Periodontal inflammation has been implicated in atherosclerosis and coronary heart disease (CHD) Coronary angiography (CA) is used in the assessment of CHD, only a few studies have evaluated periodontal disease (PD) and angiographic measures of coronary atherosclerosis The aim of this study was to investigate the association between CHD and PD In this prospective epidemiologic study, 466 patients underwent CA and were assessed for PD All patients underwent physical, laboratory, cardiac, and dental examination including dental x-rays Periodontal disease and coronary angiograms were evaluated blindly by a dentist and 2 cardiologists, respectively A coronary stenosis greater than 50% was ruled as CHD Periodontal disease was defined and measured with the Community Periodontal Index of Treatment Needs (CPITN) and if at least 2 sextants (segments dividing mandible and maxilla into 6) were recorded as having CPITN of at least 3 (signifying that sextant had periodontal pocket depth >= 3 5 mm), the patient was coded as having PD Three-hundred forty-nine patients (74 9%) had CHD assessed by CA The CHD patients had PD in 55 6% vs 41 9% in the non-CHD patients (P < 01) The CPITN scores were significantly higher in patients with vs without CHD, 2 43 vs 2 16, respectively (P = 023) After adjusting for age, sex, and risk factors for atherosclerosis with additional inclusion of C-reactive protein and erythrocyte sedimentation rate, PD remained significantly related to CHD (odds ratio = 1 9, 95% confidence interval, 1 2-3 1) Other predictors for CHD were male sex age, high-density lipoprotein cholesterol, and diabetes Our results demonstrate an increased odds ratio for angiographically determined CHD in patients with PD and that CHD and PD may cluster in particular groups of a population Our data indicate that PD represents a potentially modifiable risk factor that is both preventable and treatable with predictable treatments that pose negligible risk (C) 2011 Elsevier Inc All rights reserved
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