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Porphyromonas gingivalis (Pg) a possible link between impaired oral health and acute myocardial infarction
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
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2011 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 148, no 2, 148-153 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate if oral health parameters were impaired in patients with myocardial infarction (MI) and if there was an association with serum antibody levels against the periodontal pathogens Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa). Methods: A case-control study consisting of 100 patients with MI and 100 age- and sex-matched controls from the same geographic area was investigated regarding oral health. Results: The MI group had significantly more periodontal bone loss (PBL), number of deepened pockets (NDP), and bleeding on probing (BOP), and lower number of teeth (NT) than the controls. After adjustment for known cardiovascular risk factors NT, BOP, and NDP still remained significantly related to MI (p = 0.014, p = 0.02, and p = 0.0069, respectively). IgG antibody levels against Pg were higher in subjects with MI (p = 0.043), as well as in those with > 4 deepened pockets (p = 0.05), BOP > 20% (p = 0.001) and PBL (p = 0.0003). However, indicating a causal pathway, the relationship between MI and Pg IgG disappeared when the oral parameters were included in the logistic regression model (p = 0.69). No correlation was seen between MI and Aa in the present study. Conclusion: Patients with MI had an impaired oral health compared to controls. Furthermore, IgG levels against Pg were related to both MI and oral health, suggesting this pathogen as a possible link between oral health and CVD.

Place, publisher, year, edition, pages
2011. Vol. 148, no 2, 148-153 p.
Keyword [en]
Gingival inflammation, Periodontal disease and acute myocardial infarction, Tooth loss
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-97158DOI: 10.1016/j.ijcard.2009.10.034ISI: 000288787000011PubMedID: 19913930OAI: oai:DiVA.org:uu-97158DiVA: diva2:171974
Available from: 2008-04-28 Created: 2008-04-28 Last updated: 2011-04-20Bibliographically approved
In thesis
1. Oral health and cardiovascular disease
Open this publication in new window or tab >>Oral health and cardiovascular disease
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the past two decades studies have indicated that oral health might be associated with the prevalence for cardiovascular disease (CVD), although the biological link still remains unknown. Bacteria and inflammatory mediators causing periodontal disease have also been suggested to influence the progression of atherosclerosis.

The aims of this thesis were to study oral inflammation and associations between different oral health parameters and CVD.

Inflammatory mediators such as interleukin-1 (IL-1) as well as bone resorption activity (BRA) were significantly higher in gingival crevicular fluid (GCF) from sites with periodontal disease compared to healthy sites. Treatment resulted in a reduction of BRA as well as the levels of IL-1 for most of the diseased pockets. The levels of IL-1 were not correlated to the amount of BRA.

Number of teeth (NT) was consistently associated to CVD and was the only oral health parameter that related to all-cause mortality and mortality in CVD in a dose-dependent manner. Subjects with <10 teeth had a 7-fold increase risk for mortality in coronary heart disease compared to those with >25 teeth. Furthermore, NT was also significantly associated to the levels of leukocytes and to the metabolic syndrome, which consists of a combination of cardiovascular risk factors.

Other investigated oral health parameters, such as severity of periodontal disease, number of deepened pockets, and bleeding on probing, were not related to CVD in a consistent way.

Oral health parameters as well as myocardial infarction (MI) were related to serum antibody levels against Porphyromonas gingivalis (Pg), indicating that Pg might be a link between oral health and MI.

In conclusion, treatment reduced the increased levels of IL-1 and BRA in GCF from sites with periodontal disease. Oral health was associated to CVD with number of teeth being the only oral health parameter that consistently was associated to CVD. Serum antibody levels against P. gingivalis were related to myocardial infarction (MI) as well as to oral health parameters, suggesting that this bacteria could be a link between oral health and CVD.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 93 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 346
Medicine, Oral health, periodontal disease, number of teeth, cardiovascular disease, mortality, Medicin
urn:nbn:se:uu:diva-8708 (URN)978-91-554-7188-0 (ISBN)
Public defence
2008-05-23, Enghoffsalen, Kardiologhuset ingång 50, Akademiska sjukhuset, Uppsala, 09:15
Available from: 2008-04-28 Created: 2008-04-28Bibliographically approved

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