4.6 Article

Randomized controlled trial of the effect of periodontal treatment on cardiovascular risk biomarkers in patients with stable coronary artery disease: Preliminary findings of 3 months

Journal

JOURNAL OF CLINICAL PERIODONTOLOGY
Volume 46, Issue 3, Pages 321-331

Publisher

WILEY
DOI: 10.1111/jcpe.13085

Keywords

cardiovascular disease; C-reactive protein; cytokines; periodontal disease

Funding

  1. Brazilian Ministry of Science and Technology [CNPq 476387/2010-8]
  2. Research Support Agency from Rio Grande do Sul State [FAPERGS 1008214]
  3. Funding for Research and Events from the University Hospital of Porto Alegre

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Aim To assess the effect of periodontal therapy (PT) on cardiovascular blood biomarkers. Materials and Methods This single-blind, parallel-design, randomized controlled trial included patients with stable coronary artery disease and periodontitis. The test group (TG) received non-surgical PT, whereas the control group (CG) received one session of plaque removal. Plasma levels of C-reactive protein (CRP), glycated haemoglobin, lipids and cytokines (IL-1 beta, IL-6, IL-8, IL-10, IFN-gamma and TNF-alpha) were measured at baseline and after 3 months. Results Eighty-two patients (74.4% women, mean age 59.6 years) were analysed. TG had significantly better periodontal parameters than CG after 3 months, but no significant differences in blood markers were observed between them. In a post hoc subgroup analysis in patients with baseline CRP <3 mg/L, a significant increase in CRP was observed in CG (1.44 +/- 0.82 mg/L to 4.35 +/- 7.85 mg/L, p = 0.01), whereas CRP remained unchanged in TG (1.40 +/- 0.96 mg/L to 1.33 +/- 1.26 mg/L, p = 0.85), resulting in a significant difference between groups at 3 months. In patients with CRP >= 3 mg/L, a significant reduction in CRP was observed only in TG (11.3 +/- 12.8 mg/L to 5.7 +/- 4.1 mg/L, p = 0.04). Levels of IL-6 and IL-8 were significantly lower in TG than CG at 3 months. Conclusions PT leads to lower levels of CRP, IL-6 and IL-8 in cardiovascular patients with high CRP levels.

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