期刊
ATHEROSCLEROSIS
卷 223, 期 2, 页码 478-484出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2012.05.021
关键词
Oral pathogen burden; Inflammation; Cardiovascular disease
资金
- Sigrid Juselius Foundation
- Finnish Dental Society Apollonia
- Paulo Foundation
- Jenny and Antti Wihuri Foundation
- Finnish Foundation for Cardiovascular Research
- Aarno Koskelo Foundation
- Finnish Medical Society's Swedish Funds
- EVO funds of Helsinki University Central Hospital
Objective: The aim of this study was to investigate the association between angiographically verified coronary artery disease (CAD) and salivary levels of four major periodontal pathogens. Methods: The study population (n = 492) was composed of 179 (36.4%) patients with stable CAD, 166 (33.7%) with acute coronary syndrome (ACS), and 119 (24.2%) showing no pathological findings by coronary angiography. All patients were subjected to a detailed oral health examination. The saliva samples were analyzed for lipopolysaccharide activity as well as for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia by quantitative PCR. Serum antibodies levels against A. actinomycetemcomitans were analyzed. Results: The level of bacterial burden was linearly associated with alveolar bone loss (p < 0.001) and bleeding on probing (p = 0.015). The median salivary levels of A. actinomycetemcomitans in pathogen-positive patients were significantly higher in the Stable CAD (p = 0.014) and the ACS (p = 0.044) groups when compared to No significant CAD patients. In logistic regression models, a 10-fold increase in the salivary A. actinomycetemcomitans levels was associated with a risk for stable CAD and ACS with odds ratios (ORs) of 7.47 (95% confidence interval [CI]: 1.57-35.5, p - 0.012) and 4.31 (95% CI: 1.06-17.5, p = 0.041), respectively. The OR for the association of IgA-class antibody levels against A. actinomycetemcomitans with ACS risk was 3.13 (95% CI: 1.38-7.12, p = 0.006)/log(10) unit increase. Conclusions: High salivary levels of A. actinomycetemcomitans and systemic exposure to the bacterium were associated with increased risk for CAD. These findings emphasize the importance of oral microbiota in cardiovascular risk assessment and therapeutics. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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