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Periodontitis Increases the Risk of a First Myocardial Infarction A Report From the PAROKRANK Study
Karolinska Inst, Dept Med K2, Stockholm, Sweden..
Karolinska Inst, Dept Dent Med, Stockholm, Sweden..
Karolinska Inst, Dept Dent Med, Stockholm, Sweden..
Karolinska Inst, Dept Med K2, Stockholm, Sweden.;Karolinska Inst, Div Cardiovasc Epidemiol IMM, Stockholm, Sweden..
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2016 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 133, no 6, p. 576-583Article in journal (Refereed) Published
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Abstract [en]

Background The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. Methods and Results Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 628), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (approximate to 100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2x2 contingency tables. Contingency tables exceeding 2x2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). Conclusions In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.

Place, publisher, year, edition, pages
2016. Vol. 133, no 6, p. 576-583
Keyword [en]
case-control study, causality, myocardial infarction, periodontitis, radiography, panoramic, risk factors
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-279561DOI: 10.1161/CIRCULATIONAHA.115.020324ISI: 000369504400006PubMedID: 26762521OAI: oai:DiVA.org:uu-279561DiVA, id: diva2:908444
Funder
AFA InsuranceSwedish Heart Lung FoundationSwedish Research CouncilStockholm County Council
Available from: 2016-03-02 Created: 2016-03-02 Last updated: 2017-11-30Bibliographically approved

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