title: Acute myocardial infarct size is related to periodontitis extent and severity.
abstract: Cardiovascular disease has been associated with 40% of deaths in high-income countries and 28% in lower-income countries. The relationship between periodontitis and acute myocardial infarction is well documented, but it has not been established whether the extent and severity of periodontitis influence the infarct size. This cross-sectional and analytic study was designed to investigate the association of chronic periodontitis extent and severity with acute myocardial infarct size as indicated by serum cardiac troponin I and myoglobin levels. Sociodemographic, periodontal, cardiologic, and hematologic variables were gathered in 112 consecutive patients with myocardial infarction. The extent (Arbes Index) and severity (Periodontal Inflammatory Severity Index) of the chronic periodontitis were significantly associated with troponin I levels after controlling for sociodemographic and clinical confounders (change in R (2) = .041, p < .02, and R (2) = .031, p = .04). However, only the extent index accounted for levels of myoglobin (change in R (2) = .030, p < .05), total leukocytes (change in R (2) = .041 p < .02), and neutrophils (change in R (2) = .059, p < .01). Mediated regression analysis showed that leukocytes and neutrophils may underlie these observed relationships of chronic periodontitis with troponin I and myoglobin. To our knowledge, this study contributes the first research data demonstrating that the extent and severity of periodontitis is positively associated with acute myocardial infarct size as measured by serum troponin I and myoglobin levels.
authors.affiliation: Department of Periodontics, School of Dentistry, University of Granada, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Marfil-Álvarez
authors.affiliation: Department of Periodontics, School of Dentistry, University of Granada, Spain fmesa@ugr.es.
authors.forename: F
authors.initials: F
authors.lastname: Mesa
authors.affiliation: Department of Cardiology, "Vírgen de las Nieves" Hospital and University of Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Arrebola-Moreno
authors.affiliation: Department of Cardiology, "Vírgen de las Nieves" Hospital and University of Granada, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Ramírez-Hernández
authors.affiliation: Department of Periodontics, School of Dentistry, University of Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Magán-Fernández
authors.affiliation: Departments of Pathology, School of Medicine and Biopathology and Medicine Regenerative Institute, University of Granada, Spain.
authors.forename: F
authors.initials: F
authors.lastname: O'Valle
authors.affiliation: Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Galindo-Moreno
authors.affiliation: Department of Experimental Psychology, School of Psychology, University of Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Catena
mesh_terms: D055113:Chronic Periodontitis / Q000097:blood / Q000145:classification*; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000145:classification; D004522:Educational Status; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000145:classification*; D009211:Myoglobin / Q000097:blood; D009504:Neutrophils / Q000473:pathology; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D012737:Sex Factors; D016037:Single-Blind Method; D019210:Troponin I / Q000097:blood
chemical_list: D009211:Myoglobin; D019210:Troponin I
keywords: chronic periodontitis; myocardial infarction; myoglobin; neutrophils; troponin I; troponin T