Systemic Immunoinflammatory Markers in Periodontitis Patients With Acute Myocardial Infarction

Objectives: Intensified proinflammatory reaction in arterial walls may render atheroma plaques prone to rupture and subsequent thrombus formation leading to cardiovascular complications, such as acute myocardial infarction (AMI). After gaining access to blood circulation components from periodontal bacteria may contribute as inflammatory triggers. Here, the severity and systemic effects of periodontitis and a variety of systemic variables connected to cardiovascular risk were compared between periodontitis patients with or without a recent AMI. Methods: A total of 80 patients with periodontitis (mean age 50.3±6.7 years) were collected from Gazi University, Ankara; 40 of these periodontitis patients had been hospitalized with AMI (Per+AMI) and the remaining age- and gender-matched 40 periodontitis patients had no history of AMI (Per-AMI). In addition to demographic and life style variables, a full-mouth periodontal status was recorded and blood samples were taken on admission to hospital for inflammatory markers, lipid profile, glucose, and IgG levels against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans outer membrane proteins (OMPs) and lipopolysaccharide (LPS). IgG levels were determined by ELISA. Results: The CRP levels, white blood cell counts (WBC), glucose levels, BMI, total cholesterol, HDL-cholesterol, hypertension, smoking habits, dental plaque index, number of teeth, number of teeth with deep pockets, pocket depth, attachment level, and gingival bleeding values were significantly higher in Per+AMI than Per-AMI patients (p<0.01). IgG levels against A. actinomycetemcomitans LPS and OMP were significantly lower but those against P. gingivalis LPS and OMPs higher in periodontitis patients with than without AMI. Multiple logistic regression analysis identified the independent predictors, IgG levels against A. actinomycetemcomitans and P. gingivalis OMPs and LPS, CRP, total cholesterol, glucose levels, WBC, BMI, dental plaque, and gingival inflammation as risk factors for AMI. Conclusion: The present result indicates that periodontitis infection may contribute to an increased risk for AMI.