IADR Abstract Archives
Carotid Calcification on Panoramic Radiographs Predicts Adverse Cardiovascular Disease Outcome
Objectives: The aim was to study the prevalence of carotid artery calcification (CAC) visible on panoramic radiography in relation to coronary artery disease (CAD) severity, future outcome, and periodontal characteristics including subgingival microbiome and serology in patients who underwent coronary artery angiography.
Methods: Based on the angiography, 493 patients were divided into no significant CAD (n=120), stable CAD (n=181), acute coronary syndrome (ACS) (n=164), or ACS-like with no significant CAD (n=27), and deaths were registered during a 7-year follow-up. Detailed clinical and radiographic oral examinations were performed at baseline, and the prevalence of CAC was detected in panoramic tomography. The subgingival bacterial samples and the serum antibody levels were analyzed by using the DNA-DNA hybridization and multiserotype-ELISA. The multivariate regression models were adjusted for CAD and periodontal risk factors.
Results: CAC was present in 102 (20.7%) of the patients. In multivariate regression models, CAC associated with stable CAD (OR 1.58, 95% CI 1.15-4.76), ACS (1.58, 0.77-3.24), and three stenosed arteries (2.94, 1.41-6.11). It also associated with alveolar bone loss (2.53, 1.08-5.96), periodontitis/edentulism (2.28, 0.76-6.89), and high level of subgingival bacteria (2.25, 1.12-4.49), especially gram-negative species (2.74, 1.36-5.50), and Aggregatibacter actinomycetemcomitans (1.34, 1.03-5.33) as well as seropositivity to it (1.96, 1.03-3.74). Independently of cardiologic or periodontal diagnoses, CAC associated with increased risk of cardiovascular and all-cause death with HRs 3.89 (1.92-7.90) and 2.94 (1.69-5.10), respectively.
Conclusions: Carotid artery calcification in panoramic tomography associates firstly, with severe CAD with the worst outcome, and secondly, with periodontitis and periodontal microbiome. If carotid artery calcification is identified in panoramic radiographs, the patient should be referred for cardiovascular evaluation.
Methods: Based on the angiography, 493 patients were divided into no significant CAD (n=120), stable CAD (n=181), acute coronary syndrome (ACS) (n=164), or ACS-like with no significant CAD (n=27), and deaths were registered during a 7-year follow-up. Detailed clinical and radiographic oral examinations were performed at baseline, and the prevalence of CAC was detected in panoramic tomography. The subgingival bacterial samples and the serum antibody levels were analyzed by using the DNA-DNA hybridization and multiserotype-ELISA. The multivariate regression models were adjusted for CAD and periodontal risk factors.
Results: CAC was present in 102 (20.7%) of the patients. In multivariate regression models, CAC associated with stable CAD (OR 1.58, 95% CI 1.15-4.76), ACS (1.58, 0.77-3.24), and three stenosed arteries (2.94, 1.41-6.11). It also associated with alveolar bone loss (2.53, 1.08-5.96), periodontitis/edentulism (2.28, 0.76-6.89), and high level of subgingival bacteria (2.25, 1.12-4.49), especially gram-negative species (2.74, 1.36-5.50), and Aggregatibacter actinomycetemcomitans (1.34, 1.03-5.33) as well as seropositivity to it (1.96, 1.03-3.74). Independently of cardiologic or periodontal diagnoses, CAC associated with increased risk of cardiovascular and all-cause death with HRs 3.89 (1.92-7.90) and 2.94 (1.69-5.10), respectively.
Conclusions: Carotid artery calcification in panoramic tomography associates firstly, with severe CAD with the worst outcome, and secondly, with periodontitis and periodontal microbiome. If carotid artery calcification is identified in panoramic radiographs, the patient should be referred for cardiovascular evaluation.