Periodontal infections and coronary heart disease - Role of periodontal bacteria and importance of total pathogen burden in the coronary event and periodontal disease (CORODONT) study

被引:171
作者
Spahr, A
Klein, E
Khuseyinova, N
Boeckh, C
Muche, R
Kunze, M
Rothenbacher, D
Pezeshki, G
Hoffmeister, A
Koenig, W
机构
[1] Univ Ulm, Dept Internal Med Cardiol 2, Med Ctr, D-89081 Ulm, Germany
[2] Univ Ulm, Dept Operat Dent & Periodontol, Med Ctr, D-89081 Ulm, Germany
[3] Univ Ulm, Dept Biometry & Med documentat, Med Ctr, D-89081 Ulm, Germany
[4] German Ctr Res Aging, Dept Epidemiol, Heidelberg, Germany
关键词
D O I
10.1001/archinte.166.5.554
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Chronic inflammation from any source is associated with increased cardiovascular risk. Periodontitis is a possible trigger of chronic inflammation. We investigated the possible association between periodontitis and coronary heart disease (CHD), focusing on microbiological aspects. Methods: A total of 789 subjects ( 263 patients with angiographically confirmed, stable CHD and 526 population-based, age- and sex-matched controls without a history of CHD) were included in the Coronary Event and Periodontal Disease (CORODONT) study. Subgingival biofilm samples were analyzed for periodontal pathogens Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola using DNA-DNA hybridization. The need for periodontal treatment in each subject was assessed using the Community Periodontal Index of Treatment Needs ( CPITN). The main outcome measures included total periodontal pathogen burden, number of the various periodontal pathogens in the subgingival biofilm, and periodontal treatment needs ( according to the CPITN). Results: In multivariable analyses, we found a statistically significant association between the periodontal pathogen burden ( log(10) of the sum of all pathogens) ( odds ratio [ OR], 1.92; 95% confidence interval [CI], 1.34-2.74; P <. 001) or the number of A actinomycetemcomitans in periodontal pockets ( log10) ( OR, 2.70; 95% CI, 1.79- 4.07; P <. 001) and the presence of CHD. In addition, a statistically significant association between an increase in mean CPITN score by 1 and the presence of CHD ( OR, 1.67; 95% CI, 1.08-2.58; P=.02) was observed. Conclusions: Our findings suggest an association between periodontitis and presence of CHD. Periodontal pathogen burden, and particularly infection with A actinomycetemcomitans, may be of special importance.
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页码:554 / 559
页数:6
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