C-reactive protein in periodontitis and heart disease

Background: Elevated C-reactive protein (C-rp) levels have been reported in subjects with acute myocardial infarct (AMI) and in subjects with chronic periodontitis (CP). Aim: to assess the utility of C-rp analysis in systemically healthy subjects and in subjects with AMI in relation to their periodontal status. Methods: Serum taken from subjects at the time of emergency treatment of AMI and in systemically healthy control subjects were studied using a polyclonal anti-Crp antibody assay for high sensitive C-rp. All subjects received a comprehensive periodontal examination. Results: Data from 85 subjects with AMI (mean age 63.1, S.D. + 9.4) and 63 controls subjects (mean age 61.9, S.D.+ 9.4) (N.S.) were studied. No group differences in distribution of IDDM, or other systemic diseases were identified. C-rp levels were higher in subjects with AMI (p<0.001, n-par test). In non-AMI subjects C-rp levels were not correlated with any of 15 periodontal study parameters. Receiver characteristic curve analysis demonstrated that in confirmed medically healthy subjects C-rp values failed to discriminate between subjects with or without CP (area under the curve: 0.49, p<0.89). In AMI subjects only the proportion of sites with bleeding on probing was correlated with C-rp levels (r=0.27, p<0.02). Independent of medical status, three C-rp cut-off levels (<1.0 mg/L, <2.0 mg/L, and <3.0mg/l) also failed to discriminate between subjects with or without CP. Conclusion: Chronic periodontitis alone is not associated with elevated high sensitive C-rp values.