Clinical periodontal and microbiologic parameters in patients with acute myocardial infarction.
BACKGROUND
The aim of this study was to evaluate the impact of clinical periodontal parameters and the presence of periodontal pathogens in patients with acute myocardial infarction (AMI).


METHODS
A total of 104 subjects (54 patients with AMI and 50 healthy controls) were included. Subgingival plaque samples were analyzed for periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa; previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf; previously T. forsythensis), and Prevotella intermedia (Pi) using dot-blot hybridization.


RESULTS
Patients with AMI had a significantly higher frequency of probing depths (PDs) >or=4 mm than controls (39.2% versus 14.9%; P <0.0001). Among different cutoff levels, the frequency of >50% sites with PDs >or=4 mm showed the highest discrepancy between both groups (33% versus 0%; P <0.001). All periodontal pathogens were overrepresented in patients with AMI and positively correlated with increased periodontal PD and clinical attachment level (CAL). After adjustment for age, gender, smoking, body mass index, hypertension, plaque index, statin intake, and ratio of cholesterol to high-density lipoprotein, Pg remained a significant predictor for AMI (odds ratio [OR]: 13.6; 95% confidence interval [CI]: 3.1 to 59.8; P = 0.0005). Furthermore, the simultaneous presence of Aa + Pg (P = 0.0005) and Aa + Pg + Tf (P = 0.0018) were found with significantly higher frequency in patients with AMI than controls.


CONCLUSIONS
The results of our study confirm an association between periodontitis and AMI in which periodontal destruction was correlated with the presence of periodontal pathogens. In particular, Pg might be considered a potential risk indicator for AMI.
Department of Operative Dentistry, Perdiodontology, and Dentistry, University Hospital Aachen, Aachen, Germany. jstein@ukaachen.de
Jamal M
JM
Stein
Bernhard
B
Kuch
Georg
G
Conrads
Stefan
S
Fickl
Jaroslaw
J
Chrobot
Susanne
S
Schulz
Christina
C
Ocklenburg
Ralf
R
Smeets
D000328:Adult; D000367:Age Factors; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001439:Bacteroides / Q000302:isolation & purification; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003773:Dental Plaque / Q000382:microbiology; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000382:microbiology; D017622:Periodontal Attachment Loss / Q000145:classification / Q000382:microbiology; D010514:Periodontal Pocket / Q000145:classification / Q000382:microbiology; D010518:Periodontitis / Q000145:classification / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol