Association between periodontal disease and non-fatal ischemic stroke: a case-control study.
OBJECTIVE
This study aimed to investigate the association between clinical and radiological markers of periodontal disease and ischemic stroke and to assess the potential influence of inflammatory response on the observed associations.


METHODS
A prospective case-control study including a series of 48 cases with a minor ischemic stroke and 47 controls was conducted at the University Hospital of Dijon. Vascular risk factors, clinical dental examination (plaque index, gingival index, percentage of pockets >5 mm, percentage of bleeding on probing (BOP) sites), dental panoramic (bone loss) and biological parameters (CRP, total cholesterol, HDL, LDL, fasting glucose) were collected. Conditional regression analyses were performed to identify factors associated with ischemic stroke.


RESULTS
The prevalence of hypertension, high CRP and glucose levels and overall odontological variables was higher in stroke patients. In multivariable analyses, hypertension (OR = 12.56; 95% CI = 2.29-69.96, p = 0.004), CRP levels >5 mg/L (OR = 18.54; 95% CI = 2.01-171.17, p = 0.010), BOP (OR = 1.049; 95% CI = 1.012-1.88, p = 0.009) and bone loss >20% (OR = 1.053; 95% CI = 1.017-1.091, p = 0.004) were associated with ischemic stroke. Among stroke patients, there was a non-significant trend towards higher CRP levels in patients with bone loss >20% compared with those with bone loss <20% (8.1 ± 1.27 mg/L vs 3.12 ± 3.14 mg/L, p = 0.25), whereas other biological parameters were very similar between the two groups.


CONCLUSIONS
This case-control study demonstrates that periodontal disease, especially markers such as BOP and bone loss, is independently associated with ischemic stroke.
University of Champagne-Ardenne , Reims Cedex , France.
Arnaud
A
Lafon
Stéphane
S
Tala
Victorin
V
Ahossi
Daniel
D
Perrin
Maurice
M
Giroud
Yannick
Y
Béjot
D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002545:Brain Ischemia / Q000150:complications*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004245:DMF Index; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications*
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002097:C-Reactive Protein; D002784:Cholesterol
bone loss; ischemic; oral inflammation; periodontitis; risk factor; stroke