Periodontitis and Coronary Heart Disease Share Similar Rate of Progression

Objectives: As both diseases share prevalent chronic progression, a case-control study was performed to determine if periodontitis and CHD share a similar rate of progression.
Methods: 93 subjects had their coronaries and periodontium examined. Coronaries were examined by angiography, periodontal examination was performed following AAP guidelines. 46 had coronaries with no atheroma, 23 had to 1-4 atheromas (mean: 2.82), and 24 had ≥5 atheromas (range: 5-18, mean: 8.58). Lesions were classified by size (higher or up to 70% of stenosis), stability, and location. Periodontal variables: Clinical Attachment Level (CAL), Probing Depth (PD), Bleeding on Probing (BOP), Plaque Index (PI), number of teeth and oral hygiene were recorded. Systemic variables: Leucocytes, Monocytes, C-Reactive Protein (CRP), Fibrinogen, High-Density Cholesterol (HDL), Low-Density Cholesterol (LDL), and Triglycerides.
Results: After ANOVA, ↑atheromas was associated with ↑Leucocytes (p=0.003), with ↑Monocytes (p<0.001), with ↑Fibrinogen (p=0.004), with ↑CRP (0.005) and with ↓HDL (p<0.001). Subjects with ↑atheromas change their toothbrushes less often (p=0.019), have more active periodontitis (p=0.04) and ↑mean PD (p=0.05). Although CAL>3mm was associated with ↑atheromas (p=0.047) and CAL>7mm was associated with ≥5 atheromas (p=0.035), no associations were observed between Periodontitis’ stage, number of teeth, age and prevalence of hypertension. Spearman’s correlation indicated active periodontitis as an independent risk factor for larger atheroma (p<0.001) and ↑affected coronaries (p=0.037). ↑mean PD was an independent risk factor for larger atheroma (p=0.003).
Conclusions: CAL presents a rate of progression that mirrors a greater amount of atheroma in the same patients. Active Periodontitis with deeper PD is an independent risk factor for atheroma formation and size, and could be considered, combined with systemic inflammatory and dyslipidemia markers, a predictor of coronary atheroma and CHD.