title: Periodontitis in patients with coronary artery disease: an 8-year follow-up.
abstract: BACKGROUND
  This study examines whether preceding assessment of periodontal status in patients with established coronary artery disease (CAD) can predict future CAD endpoints (myocardial infarction, new revascularization procedure, or CAD-related death) during 8-year follow-up and whether the changes in periodontal status over time differ in patients with CAD compared with healthy controls.
  
  
  METHODS
  In 2003, periodontal status was examined in 161 patients with CAD who underwent percutaneous coronary intervention or coronary artery bypass graft due to significant stenosis in the coronary arteries and 162 controls without CAD. Eight years later, 126 patients with CAD (102 males and 24 females, mean age: 68 ± 8.9 years) and 121 controls (101 males and 20 females, mean age: 69 ± 9.0 years) were reexamined periodontally. A standard classification of periodontal disease in three groups (mild, moderate, and severe) was used. CAD endpoints during follow-up were obtained by review of medical records. CAD as cause of death was confirmed from the Swedish Cause of Death Register.
  
  
  RESULTS
  No significant differences were found among patients with CAD, with or without CAD-related endpoints at 8-year follow-up, and severity of periodontitis at baseline (P = 0.7). CAD did not influence the incidence or severity of periodontitis. Significant differences were found at the final examination in periodontitis prevalence and severity (P = 0.001), number of teeth (P = 0.006), probing depth 4 to 6 mm (P = 0.016), bleeding on probing (P = 0.001), and radiographic bone level (P = 0.042) between CAD patients and controls, all in favor of controls.
  
  
  CONCLUSIONS
  The study results did not show a significant association during 8 years among CAD endpoints and periodontal status at baseline. The progression of periodontitis was low in both groups, although the higher proportion of individuals with severe periodontitis among patients with CAD compared with controls remained unchanged over the 8-year follow-up. Further long-term prospective studies are needed to show whether periodontitis can be considered a risk or prognostic factor for CAD, in terms of endpoints including myocardial infarction, new revascularization procedure, and CAD-related death.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Carin Starkhammar
authors.initials: CS
authors.lastname: Johansson
authors.forename: Nils
authors.initials: N
authors.lastname: Ravald
authors.forename: Christos
authors.initials: C
authors.lastname: Pagonis
authors.forename: Arina
authors.initials: A
authors.lastname: Richter
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications; D016022:Case-Control Studies; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications*; D023921:Coronary Stenosis / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D062645:Percutaneous Coronary Intervention; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000150:complications; D010518:Periodontitis / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D016388:Tooth Loss / Q000150:complications