title: Periodontal disease is associated with higher levels of C-reactive protein in non-diabetic, non-smoking acute myocardial infarction patients.
abstract: OBJECTIVE
  A link between periodontal disease (PD) and cardiovascular events has been proposed, but confounding by shared risk factors such as smoking and diabetes remains a concern. We examined the prevalence of PD and its contribution to C-reactive protein (CRP) levels in acute myocardial infarction (AMI) patients and in subjects without AMI and with angiographically nonobstructive coronary disease in the absence of these confounding risk factors.
  
  
  METHODS
  Periodontal status and admission CRP levels were evaluated in 87 non-diabetic and non-smoking subjects undergoing cardiac catheterization. The study group comprised of 47 patients with documented AMI, and 40 subjects without AMI and with angiographically nonobstructive coronary disease (ANCD group).
  
  
  RESULTS
  Both the prevalence of PD and CRP levels were significantly higher in AMI patients compared with ANCD subjects (38.3% vs. 17.5%, p=0.03 and 44.3 vs. 8.5 mg/L, p<0.001 respectively). PD was associated with higher CRP levels in AMI patients (52.5 vs. 36.1 mg/L, p=0.04) as well as in ANCD subjects, however, in this group this was not significant (12.6 vs. 7.6 mg/L, p=0.5). Multivariable regression analysis confirmed two separate measures of PD as strong and independent contributors to elevated CRP levels in AMI patients (R2 = 0.28, R2 = 0.30, p=0.001).
  
  
  CONCLUSIONS
  PD contributes to elevated CRP levels in non-diabetic, non-smoking AMI patients, independently of other confounding factors. These findings imply that periodontitis may emerge as a novel target for reducing future risk in AMI survivors.
authors.affiliation: Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece. gkodo@yahoo.com
authors.forename: George
authors.initials: G
authors.lastname: Kodovazenitis
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Lambros
authors.initials: L
authors.lastname: Papadimitriou
authors.forename: Efthymios N
authors.initials: EN
authors.lastname: Deliargyris
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vrotsos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Phoebus N
authors.initials: PN
authors.lastname: Madianos
mesh_terms: D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000150:complications; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D005884:Gingival Hemorrhage / Q000097:blood / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D017622:Periodontal Attachment Loss / Q000097:blood / Q000150:complications; D010510:Periodontal Diseases / Q000097:blood* / Q000150:complications; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000097:blood / Q000150:complications; D010518:Periodontitis / Q000097:blood / Q000150:complications; D016388:Tooth Loss / Q000150:complications; D019210:Troponin I / Q000097:blood
chemical_list: D019210:Troponin I; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form