High-sensitivity serum C-reactive protein levels in subjects with or without myocardial infarction or periodontitis

Background: Serum high-sensitivity C-reactive protein (hsC-rp) is a non-specific marker of inflammation. Elevated hsC-rp levels are found in subjects with cardiovascular diseases (CVDs). Periodontitis may influence hsC-rp levels. Objectives: To assess periodontal status and hsC-rp serum levels in consecutive subjects hospitalized and diagnosed with acute myocardial infarction (AMI) (n=85) and in a group of carefully matched subjects (gender, age social, ethnic, and smoking habits) without clinical evidence of CVD (n=63). Methods: hsC-rp levels, other routine serum values, and clinical periodontal conditions were studied. Results: Subjects with AMI had higher hsC-rp levels than control subjects (p < 0.001, Mann-Whitney U-test). The odds that subjects in the control group with periodontitis (30% or more sites with > 4.0 mm loss of alveolar bone) had serum hsC-rp > 1.8 mg/l was 1.5 (95% CI: 1.1-7.3, p < 0.05). Stepwise linear regression analysis failed to include periodontal parameters in an explanatory model to hsC-rp values. Only the serum leucocyte (white blood cell (WBC)) counts were explanatory to hsC-rp values (beta standard coefficient=0.45, t=3.2, p < 0.001). Serum WBC counts were significantly higher in control subjects with periodontitis (p < 0.03) but not in subjects in the AMI group (p < 0.57). Conclusions: (1) As expected, elevated serum hsC-rp concentration and serum WBC counts are associated with acute coronary heart disease. (2) Elevated serum hsC-rp values are associated with radiographically defined periodontitis in subjects with no evidence of CVD. (3) Periodontal parameters are not explanatory to elevated serum hsC-rp values if serum WBC and low-density lipoprotein counts are included in the regression model.