Periodontal Disease and its Association with Angiographically Verified Coronary Artery Disease.
OBJECTIVE
The aim of this research was to investigate the association of chronic and aggressive periodontitis with the severity of coronary artery disease which was angiographically verified.


METHODS
Subjects were selected among the hospitalized patients at the University Hospital Centre Zagreb who had coronary angiography done because of the chest pain. Thorough clinical examination included periodontal indices and clinical and socio-demographic characteristics of participants. Subjects were divided in two test groups, acute coronary syndrome (ACS) and stable coronary artery disease (CAD), and the control group with no significant CAD. Data were analyzed using Kruskal-Wallis and Pearson's Chi-Square test.


RESULTS
From 106 subjects, 66 (62.3%) were hospitalized for ACS, 22 (20.7%) had stable CAD and only 18 (17.0%) had no significant CAD. Only 26 (24.5%) out of 106 patients were never smokers (p<0.05). Chronic periodontitis was the most common finding with 68.2% in ACS group and 54.5% in stable CAD group, while healthy patients without periodontitis (72.6%) were dominant in the control group (p<0.001). Stable CAD group had the highest mean probing depth (PD) 3.92±1.16, gingival recession (GR) 1.34±0.78, clinical attachment level (CAL) 4.60±1.41 and bleeding on probing (BOP) 45.98±26.19 values, whereas ACS group had mean PD value of 3.77±0.91, GR 1.11±0.66, CAL 4.32±1.08 and BOP 41.30±22.09, and no significant CAD group had mean PD value of 3.27±0.97, GR 0.69±0.37, CAL 3.62±1.04 and BOP 26.39±13.92 (p<0.05).


CONCLUSIONS
Periodontitis was shown to be associated with angiographically verified coronary artery disease. Physical inactivity, poor oral hygiene and periodontal inflammation were observed in patients with ACS and stable CAD.
Zavod za parodontologiju Stomatološkog fakulteta Sveučilišta u Zagrebu i Klinički zavod za parodontologiju Kliničkog bolničkog centra Zagreb, Hrvatska Department of Periodontology, School of Dental Medicine, and Clinical Department of Periodontology, Clinical Hospital Center Zagreb, Croatia.
Domagoj
D
Vražić
Klinika za bolesti srca i krvnih žila Kliničkog bolničkog centra Zagreb, Hrvatska Department for Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia.
Zoran
Z
Miovski
Klinika za bolesti srca i krvnih žila Kliničkog bolničkog centra Zagreb, Hrvatska Department for Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia.
Maja
M
Strozzi
Zavod za parodontologiju Stomatološkog fakulteta Sveučilišta u Zagrebu i Klinički zavod za parodontologiju Kliničkog bolničkog centra Zagreb, Hrvatska Department of Periodontology, School of Dental Medicine, and Clinical Department of Periodontology, Clinical Hospital Center Zagreb, Croatia.
Ivan
I
Puhar
Zavod za parodontologiju Stomatološkog fakulteta Sveučilišta u Zagrebu i Klinički zavod za parodontologiju Kliničkog bolničkog centra Zagreb, Hrvatska Department of Periodontology, School of Dental Medicine, and Clinical Department of Periodontology, Clinical Hospital Center Zagreb, Croatia.
Ana
A
Badovinac
Zavod za parodontologiju Stomatološkog fakulteta Sveučilišta u Zagrebu i Klinički zavod za parodontologiju Kliničkog bolničkog centra Zagreb, Hrvatska Department of Periodontology, School of Dental Medicine, and Clinical Department of Periodontology, Clinical Hospital Center Zagreb, Croatia.
Darko
D
Božić
Zavod za parodontologiju Stomatološkog fakulteta Sveučilišta u Zagrebu i Klinički zavod za parodontologiju Kliničkog bolničkog centra Zagreb, Hrvatska Department of Periodontology, School of Dental Medicine, and Clinical Department of Periodontology, Clinical Hospital Center Zagreb, Croatia.
Darije
D
Plančak
Cardiovascular Diseases; Coronary Angiography; Coronary Artery Disease; Periodontal Index; Periodontitis
JAMA. 2013 Jan 2;309(1):71-82
23280227
Croat Med J. 2006 Feb;47(1):95-102
16489702
J Clin Periodontol. 2013 Apr;40 Suppl 14:S106-12
23627322
MMWR Suppl. 1989 Mar 24;38(2):1-32
2494426
J Clin Periodontol. 2011 Nov;38(11):1007-14
22092472
J Dent Res. 2005 Oct;84(10):924-30
16183792
J Periodontol. 2013 Apr;84(4 Suppl):S51-69
23631584
Rev Esp Cardiol. 2008 Mar;61(3):299-310
18361904
N Engl J Med. 2006 Aug 24;355(8):763-78
16926275
N Engl J Med. 2007 Mar 1;356(9):911-20
17329698
Stroke. 2003 Sep;34(9):2120-5
12893951
J Periodontol. 2013 Apr;84(4 Suppl):S70-84
23631585
Arterioscler Thromb Vasc Biol. 2001 Nov;21(11):1816-22
11701471
Coll Antropol. 2000 Jun;24(1):69-78
10895534
Am J Pathol. 1998 Oct;153(4):1023-33
9777934
J Periodontol. 2005 Nov;76(11 Suppl):2075-84
16277579
Am J Epidemiol. 2000 Feb 1;151(3):273-82
10670552
J Periodontol. 2009 Feb;80(2):190-201
19186958
J Clin Periodontol. 2013 Apr;40 Suppl 14:S85-105
23627337
Ann Periodontol. 1998 Jul;3(1):127-41
9722697
J Periodontol. 2004 Feb;75(2):196-209
15068107
J Periodontol. 2013 Apr;84(4 Suppl):S20-3
23631580
J Periodontol. 2013 Apr;84 Suppl 4S:S24-S29
29537596
J Gen Intern Med. 2008 Dec;23(12):2079-86
18807098
J Clin Periodontol. 2013 Apr;40 Suppl 14:S30-50
23627333
MMWR Morb Mortal Wkly Rep. 1990 Sep 28;39(38):653-6
2118979
Circulation. 2008 Apr 1;117(13):1668-74
18362228