title: Porphyromonas gingivalis (Pg) a possible link between impaired oral health and acute myocardial infarction.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Periodontology, The County Hospital of Gävle, Centre for Research and Development Uppsala University/County Council of Gävleborg, Sweden. anders.holmlund@lg.se
authors.forename: Anders
authors.initials: A
authors.lastname: Holmlund
authors.forename: Måns
authors.initials: M
authors.lastname: Hedin
authors.forename: Pirkko J
authors.initials: PJ
authors.lastname: Pussinen
authors.forename: Ulf H
authors.initials: UH
authors.lastname: Lerner
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
mesh_terms: D000189:Actinobacillus Infections / Q000453:epidemiology / Q000276:immunology; D016976:Aggregatibacter actinomycetemcomitans / Q000276:immunology; D016301:Alveolar Bone Loss / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D000907:Antibodies, Bacterial / Q000097:blood; D016866:Bacteroidaceae Infections / Q000453:epidemiology* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology*; D009909:Oral Health; D010518:Periodontitis / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000276:immunology; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G