title: Antibodies to periodontal pathogens are associated with coronary plaque remodeling but not with vulnerability or burden.
abstract: OBJECTIVE
  Previous studies have suggested positive associations between periodontal infection and cardiovascular disease. We aimed to investigate the associations of circulating antibodies against periodontal pathogens with 1-year cardiovascular outcome, as well as the extent of coronary atherosclerosis, plaque vulnerability and lesion remodeling on intravascular ultrasound (IVUS) imaging.
  
  
  METHODS
  Between 2008 and 2011, radiofrequency IVUS imaging of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography. Immunoglobulin G (IgG) and A (IgA) against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Prevotella intermedia were measured in plasma.
  
  
  RESULTS
  None of the antibody levels were associated with coronary plaque burden, radiofreqeuncy-IVUS-derived thin-cap fibroatheroma lesion morphology or 1-year incidence of major adverse cardiac events (MACE), which included all-cause mortality, acute coronary syndrome and unplanned coronary revascularization. IgA against A. actinomycetemcomitans, T. forsythia and P. intermedia were inversely associated with extent of positive lesion remodeling (OR for highest versus lowest tertile 0.55, 95%CI 0.35-0.88, p = 0.012; 0.53, 95%CI 0.32-0.87, p = 0.012; and 0.64, 95%CI 0.40-1.02, p = 0.061, respectively). In diabetic patients specifically, IgG against P. gingivalis tended to be associated with coronary plaque burden (p = 0.080), while IgA against P. gingivalis tended to be associated with incident MACE (p = 0.060).
  
  
  CONCLUSIONS
  Plasma IgG and IgA against major periodontal pathogens were not associated with the extent of coronary atherosclerosis (with the exception of a trend in diabetics) nor with coronary plaque vulnerability. IgA against periodontal pathogens were inversely associated with extent of coronary remodeling. Altogether, these results do not add evidence for a substantial role of systemic exposure to periodontal pathogens in coronary artery disease.
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Sanneke P M
authors.initials: SP
authors.lastname: de Boer
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Jin M
authors.initials: JM
authors.lastname: Cheng
authors.affiliation: INSERM UMRS 1148 Laboratory for Vascular Translational Science, Bichat Hospital, Paris, France; Periodontology Department, Rothschild Hospital, Paris, France; UFR of Odontology, Paris Diderot University, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Rangé
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Heo
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: K Martijn
authors.initials: KM
authors.lastname: Akkerhuis
authors.affiliation: INSERM UMRS 1148 Laboratory for Vascular Translational Science, Bichat Hospital, Paris, France; CHU de La Réunion, Saint-Denis, La Réunion, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Meilhac
authors.affiliation: INSERM UMRS 1148 Laboratory for Vascular Translational Science, Bichat Hospital, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cosler
authors.affiliation: Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors.forename: Pirkko J
authors.initials: PJ
authors.lastname: Pussinen
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.affiliation: Erasmus MC, Department of Cardiology, Rotterdam, The Netherlands. Electronic address: i.kardys@erasmusmc.nl.
authors.forename: Isabella
authors.initials: I
authors.lastname: Kardys
mesh_terms: D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans; D000907:Antibodies, Bacterial / Q000097:blood*; D050197:Atherosclerosis; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000382:microbiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000382:microbiology / Q000503:physiopathology; D010641:Phenotype; D058226:Plaque, Atherosclerotic / Q000382:microbiology* / Q000473:pathology*; D016966:Porphyromonas gingivalis; D018713:Prevotella intermedia; D011379:Prognosis; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D066253:Vascular Remodeling
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G
keywords: Atherosclerosis; Coronary artery disease; Periodontitis; Prognosis; Serology