ASSOCIATION OF SEVERITY OF PERIODONTITIS WITH NGIOGRAPHIC EXTENT OF STABLE CORONARY ARTERY DISEASE: A CLINICAL AND INFLAMMATORY MARKER EVALUATION

Objectives: Cardiovascular diseases are the leading causes of death in the west. Recently, a downward trend in incidence and mortality rates has been reported in many countries, including Iran. For years, dentists have been aware that certain characteristics are common to patients with periodontitis and patients with cardiovascular disease. Research has shown that atherosclerosis is more common in patients with periodontitis. This suggests that periodontal disease and cardiovascular disease may have similar causative pathways. The aim of the present case-control study was to examine the association between periodontal disease and CAD, utilizing angiographic data in subjects without evidence of recent acute MI, to firmly establish CAD-positive (+) and CAD negative (-) status.

Methods: One hundred and sixty five patients with medical histories suggestive of having CAD and scheduled for coronary angiography (CA) consented to enroll in this study.  This included patients who had an indication to undergo CA.  These indications included history of stable typical chest pain, atypical chest pain with positive myocardial SPECT scan imaging and positive exercise tolerance test. Patients undergoing CA after acute cardiac events, evaluation of previous coronary interventions i.e. coronary artery bypass grafting and percutaneous transcoronary angioplasty, or evaluation of stenoses in patients with already documented CAD, based on previous CAs, were excluded.  Other exclusion criteria were: age less than 40 years, diabetes mellitus, presence of factors requiring antiobiotic prophylaxis prior to a dental examination and being completely edentulous. Periodontal examination was carried out by the principle investigator under supervision by supervisors, and the following data were obtained regarding presence and severity of periodontitis: I. Bleeding on probing, II. Probing depth, III. Clinical attachment level (CAL).

Results: Periodontitis was more prevalent in patients with Coronary artery disease; it was also more diffuse in patients with CAD.

Conclusions:  There was a strong association between periodontitis and CAD.

Keywords: Periodontitis, Coronary Artery Diseases.