Periodontitis: a future risk of acute coronary syndrome? A follow-up study over 3 years.
BACKGROUND
Periodontitis has been associated with cardiovascular disease. We assess if the recurrence of acute coronary syndrome (ACS) could be predicted by preceding medical and periodontal conditions.


METHODS
A total of 165 consecutive subjects with ACS and 159 medically healthy, matched control subjects were examined and followed for 3 years. Periodontitis was defined by alveolar bone loss. Subgingival microbial samples were studied by the checkerboard DNA-DNA hybridization method.


RESULTS
The recurrence of ACS was found in 66 of 165 (40.0%) subjects, and a first ACS event was found in seven of 159 (4.4%) subjects among baseline control subjects. Subjects who later had a second ACS event were older (P <0.001). Significantly higher serum levels of high-density lipoprotein (P <0.05), creatinine (P <0.01), and white blood cell (WBC) counts (P <0.001) were found in subjects with future ACS. Periodontitis was associated with a first event of ACS (crude odds ratio [OR]: 10.3:1; 95% confidence interval [CI]: 6.1 to 17.4; P <0.001) and the recurrence of ACS (crude OR: 3.6:1; 95% CI: 2.0 to 6.6; P <0.001). General linear modeling multivariate analysis, controlling for age and the prediction of a future ACS event, identified that WBC counts (F = 20.6; P <0.001), periodontitis (F = 17.6; P <0.001), and serum creatinine counts (F = 4.5; P <0.05) were explanatory of a future ACS event.


CONCLUSIONS
The results of this study indicate that recurrent ACS events are predicted by serum WBC counts, serum creatinine levels, and a diagnosis of periodontitis. Significantly higher counts of putative pathogens are found in subjects with ACS, but these counts do not predict future ACS events.
Renvert
Stefan
S
Department of Health Sciences, University of Kristianstad, Kristianstad, Sweden.
Ohlsson
Ola
O
Pettersson
Thomas
T
Persson
G Rutger
GR
D054058:Acute Coronary Syndrome / Q000209:etiology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000150:complications / Q000382:microbiology; D001419:Bacteria / Q000145:classification; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D010518:Periodontitis / Q000150:complications* / Q000382:microbiology; D011188:Potassium / Q000097:blood; D012008:Recurrence; D012307:Risk Factors; D012964:Sodium / Q000097:blood
D002097:C-Reactive Protein; D002784:Cholesterol; D003404:Creatinine; D004269:DNA, Bacterial; D006442:Glycated Hemoglobin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D011188:Potassium; D012964:Sodium