Dental Infection and the Risk of New Coronary Events: Prospective Study of Patients with Documented Coronary Artery Disease

Mattila, Kimmo; Valtonen, Ville; Nieminen, Markku S.; Huttunen, Jussi K.

doi:10.1093/clinids/20.3.588

Cited by 299 publications

(230 citation statements)

References 25 publications

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“…In addition, we compared the explanatory ability of the ADS to that of the TDI, formulated by Mattila et al 15 To observe clinically meaningful robust changes, we created an ordinal scale of ADS under the assumption that an increased score would be associated with an increased risk of CHD. To make a fair comparison, we also created a TDI scale with the same assumption.…”

Section: Validationmentioning

confidence: 99%

Asymptotic Dental Score and Prevalent Coronary Heart Disease

et al. 2004

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Background-Oral infections have been postulated to produce cytokines that may contribute to the pathogenesis of coronary heart disease (CHD). We hypothesized that by estimating the combined production of inflammatory mediators attributable to several oral pathologies, we might be able to explain CHD with better precision. Methods and Results-A total of 256 consecutive Finnish cardiac patients from Kuopio University Hospital with angiographically confirmed CHD and 250 age-, gender-, and residence-matched noncardiac patients (controls) were recruited. All dental factors expected to generate inflammatory mediators, including pericoronitis, dental caries, dentate status, root remnants, and gingivitis, were examined, and an asymptotic dental score (ADS) was developed by logistic regression analyses with an appropriate weighting scheme according to the likelihood ratio. We validated the explanatory ability of ADS by comparing it to that of the Total Dental Index and examining whether the ADS was associated with known predictors of CHD. A model that included ADS, C-reactive protein, HDL, and fibrinogen offered an explanatory ability that equaled or exceeded that of the Framingham heart score (C statisticϭ0.82 versus 0.80). When ADS was removed from this model, the C-statistic decreased to 0.77, which indicates that the ADS was a significant contributor to the explanatory ability of a logistic model. Conclusions-ADS may be useful as a prescreening tool to promote proactive cardiac evaluation among individuals without overt symptoms of CHD. However, additional prospective study is needed to validate the use of an oral health score as a predictor of incident CHD.

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Section: Validationmentioning

confidence: 99%

Asymptotic Dental Score and Prevalent Coronary Heart Disease

et al. 2004

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“…2 Moreover, an association has been shown to exist among chronic infections, inflammatory markers, and CHD. [2][3][4] The concept that chronic infection plays a role in the pathogenesis of CHD may have important clinical implications. Current research on the infective hypothesis of CHD has focused mainly on Chlamydia pneumoniae and Helicobacter pylori.…”

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confidence: 99%

Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

et al. 2002

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Background-Infection with Helicobacter pylori and Chlamydia pneumoniae is associated with coronary heart disease.We conducted an intervention study using antibiotics against these bacteria in patients with acute coronary syndromes to determine whether antibiotics reduce inflammatory markers and adverse cardiac events. Methods and Results-Patients (nϭ325) admitted with acute myocardial infarction or unstable angina (acute coronary syndromes) were randomized to receive a 1-week course of 1 of 3 treatment regimens: (1) placebo; (2) amoxicillin (500 mg twice daily), metronidazole (400 mg twice daily), and omeprazole (20 mg twice daily); or (3) azithromycin (500 mg once daily), metronidazole (400 mg twice daily), and omeprazole (20 mg twice daily). Serum fibrinogen, white cell count, and high-sensitivity C-reactive protein were measured at study entry and at 1, 3, and 12 months during follow-up. Cardiac death and readmission with acute coronary syndrome were considered clinical end points. Patients were followed for 1 year. C-reactive protein levels were reduced (Pϭ0.03) in unstable angina patients receiving amoxicillin, and fibrinogen was reduced in both patient groups receiving antibiotics (Pϭ0.06). There were 17 cardiac deaths and 71 readmissions with acute coronary syndrome. No difference in frequency or timing of end points was observed between the 2 antibiotic groups. At 12 weeks, there was a 36% reduction in all end points in patients receiving antibiotics compared with placebo (Pϭ0.02). This reduction persisted during the 1-year follow-up. Neither C pneumoniae nor H pylori antibody status was significantly related to response to treatment. Conclusions-Antibiotic treatment significantly reduced adverse cardiac events in patients with acute coronary syndromes, but the effect was independent of H pylori or C pneumoniae seropositivity.

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“…In a 7-year CHD and also for further coronary events. The study by Beck et al 23 confirmed the findings of these investigators, 24 indicating that periodontal disease may be a risk factor for CHD. Beck et al 23 reported that subjects with the most severe probing depths and bone loss at baseline had higher risk for developing CHD than those with minimal periodontal disease.…”

Section: Discussionmentioning

confidence: 58%

Plasma Fibrinogen Levels in Chronic Periodontitis Subjects: A Pilot Study

Dhawle¹

2018

jmscr

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Periodontitis is a chronic inflammatory condition of tooth supporting structures that may lead to tooth loss. Periodontitis has been considered as a risk factor for various systemic diseases that affect the human health. Cardiovascular Diseases is one of them. The various systemic inflammatory markers associated with Cardiovascular Diseases, actually increase the inflammatory activity in atherosclerotic lesions, potentially increasing the risk for cardiac or cerebro vascular events. Amongst the different inflammatory markers, plasma Fibrinogen is a classical positive acute-phase reactant considered to be an independent predictor of coronary heart disease. Various studies have shown that periodontitis is responsible for increase in systemic inflammatory markers. Very few studies have mentioned about the increase inPlasma fibrinogen levels in chronic periodontitis subjects. This pilot study was therefore planned to assess plasma fibrinogen levels in chronic periodontitis subjects.

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Dental Infection and the Risk of New Coronary Events: Prospective Study of Patients with Documented Coronary Artery Disease

Cited by 299 publications

References 25 publications

Asymptotic Dental Score and Prevalent Coronary Heart Disease

Asymptotic Dental Score and Prevalent Coronary Heart Disease

Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

Plasma Fibrinogen Levels in Chronic Periodontitis Subjects: A Pilot Study

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