Periodontal infections and coronary heart disease: role of periodontal bacteria and importance of total pathogen burden in the Coronary Event and Periodontal Disease (CORODONT) study.
BACKGROUND
Chronic inflammation from any source is associated with increased cardiovascular risk. Periodontitis is a possible trigger of chronic inflammation. We investigated the possible association between periodontitis and coronary heart disease (CHD), focusing on microbiological aspects.


METHODS
A total of 789 subjects (263 patients with angiographically confirmed, stable CHD and 526 population-based, age- and sex-matched controls without a history of CHD) were included in the Coronary Event and Periodontal Disease (CORODONT) study. Subgingival biofilm samples were analyzed for periodontal pathogens Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola using DNA-DNA hybridization. The need for periodontal treatment in each subject was assessed using the Community Periodontal Index of Treatment Needs (CPITN). The main outcome measures included total periodontal pathogen burden, number of the various periodontal pathogens in the subgingival biofilm, and periodontal treatment needs (according to the CPITN).


RESULTS
In multivariable analyses, we found a statistically significant association between the periodontal pathogen burden (log10 of the sum of all pathogens) (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.34-2.74; P<.001) or the number of A actinomycetemcomitans in periodontal pockets (log10) (OR, 2.70; 95% CI, 1.79-4.07; P<.001) and the presence of CHD. In addition, a statistically significant association between an increase in mean CPITN score by 1 and the presence of CHD (OR, 1.67; 95% CI, 1.08-2.58; P = .02) was observed.


CONCLUSIONS
Our findings suggest an association between periodontitis and presence of CHD. Periodontal pathogen burden, and particularly infection with A actinomycetemcomitans, may be of special importance.
Department of Operative Dentistry and Periodontology, University of Ulm Medical Center, Ulm, Germany.
Axel
A
Spahr
Elena
E
Klein
Natalie
N
Khuseyinova
Clemens
C
Boeckh
Rainer
R
Muche
Markus
M
Kunze
Dietrich
D
Rothenbacher
Gita
G
Pezeshki
Albrecht
A
Hoffmeister
Wolfgang
W
Koenig
D000328:Adult; D000368:Aged; D001438:Bacteroidaceae / Q000235:genetics / Q000302:isolation & purification*; D016866:Bacteroidaceae Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D002908:Chronic Disease; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D010519:Periodontium / Q000382:microbiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D004269:DNA, Bacterial