title: Bacterial profile and burden of periodontal infection in subjects with a diagnosis of acute coronary syndrome.
abstract: BACKGROUND
  Periodontitis has been identified as a potential risk factor in cardiovascular diseases. It is possible that the stimulation of host responses to oral infections may result in vascular damage and the inducement of blood clotting. The aim of this study was to assess the role of periodontal infection and bacterial burden as an explanatory variable to the activation of the inflammatory process leading to acute coronary syndrome (ACS).
  
  
  METHODS
  A total of 161 consecutive surviving cases admitted with a diagnosis of ACS and 161 control subjects, matched with cases according to their gender, socioeconomic level, and smoking status, were studied. Serum white blood cell (WBC) counts, high- and low-density lipoprotein (HDL/LDL) levels, high-sensitivity C-reactive protein (hsC-rp) levels, and clinical periodontal routine parameters were studied. The subgingival pathogens were assayed by the checkerboard DNA-DNA hybridization method.
  
  
  RESULTS
  Total oral bacterial load was higher in the subjects with ACS (mean difference: 17.4x10(5); SD: 10.8; 95% confidence interval [CI]: 4.2 to 17.4; P<0.001), and significant for 26 of 40 species including Porphyromonas gingivalis, Tannerella forsythensis, and Treponema denticola. Serum WBC counts, hsC-rp levels, Streptococcus intermedius, and Streptococcus sanguis, were explanatory factors to acute coronary syndrome status (Nagelkerke r2=0.49).
  
  
  CONCLUSIONS
  The oral bacterial load of S. intermedius, S. sanguis, Streptococcus anginosus, T. forsythensis, T. denticola, and P. gingivalis may be concomitant risk factors in the development of ACS.
authors.affiliation: Department of Health Sciences, Kristianstad University, and Department of Medicine, Central Hospital, Kristianstad, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Renvert
authors.forename: Thomas
authors.initials: T
authors.lastname: Pettersson
authors.forename: Ola
authors.initials: O
authors.lastname: Ohlsson
authors.forename: G Rutger
authors.initials: GR
authors.lastname: Persson
mesh_terms: D001439:Bacteroides / Q000472:pathogenicity; D016022:Case-Control Studies; D002908:Chronic Disease; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000382:microbiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D010518:Periodontitis / Q000097:blood / Q000150:complications* / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000472:pathogenicity; D012307:Risk Factors; D018709:Statistics, Nonparametric; D034366:Streptococcus anginosus / Q000472:pathogenicity; D034367:Streptococcus intermedius / Q000472:pathogenicity; D013298:Streptococcus sanguis / Q000472:pathogenicity; D013577:Syndrome; D048373:Treponema denticola / Q000472:pathogenicity