Periodontal condition in Japanese coronary heart disease patients: A comparison between coronary and non‐coronary heart diseases

Abstract

Objective The aim of this clinical trial was to assess the relationship between periodontal bacterial burden and coronary heart disease (CHD) in Japanese population. Background Many epidemiological reports suggest that periodontitis is a risk factor for CHD; however, the influence of each periodontal bacterium and periodontal condition in Japanese CHD patients is unclear. Methods We studied 897 patients with cardiovascular diseases in Tokyo Medical and Dental University Hospital from May 2012 to August 2015. The subjects were divided into six groups according to age and the existence of CHD (46‐60 years with CHD (n = 56): Group YC, 61‐70 years with CHD (n = 106): Group MC, over 70 years with CHD (n = 177): Group EC, 46‐60 years without CHD (n = 152): Group YN, 61‐70 years without CHD (n = 216): Group MN, and over 70 years without CHD (n = 190): Group EN). Results We found that the patients in Groups MC and EC had deeper periodontal pocket compared to the patients in Group YN (P < 0.05), although there was no statistical difference of pocket depth between Group YC and Groups MC and EC. Many subjects in Group EC had high anti‐Porphyromonas gingivalis and anti‐Prevotella intermedia antibodies in comparison to Group EN (P < 0.05). The CHD patients generally had worse oral condition than the non‐CHD patients. Elderly with CHD had a higher level of serum anti‐Porphyromonas gingivalis antibody and anti‐Prevotella intermedia antibody than those without CHD. Conclusion Increased periodontal infection was found in Japanese CHD patients compared to non‐CHD patients.

Is there evidence that periodontal diseases are risk factors for coronary arterial disease?—Scoping review

“…Seven papers were duplicated across different databases and were also excluded. Applying inclusion and exclusion criteria, 29 publications were excluded during screening, and nine exclusions occurred during the eligibility phase, which resulted in 34 remaining studies 5,6,8,12–42 (Table 1). Reference lists checking did not yield in new inclusions.…”

“…Even though a wide advantage was found among included papers with favorable opinions, the predominant study design was the cross‐sectional 6,12,14,19,22–24,30,36 . However, cross‐sectional studies often feature a higher level of bias due to associate methodological flaws, which by its turn lead to a weaker strength to form evidence.…”

“…Considering the parameters of evidence, for the researched period of time, observational studies 6,8,[12][13][14]16,18,19,[22][23][24][25][26][27][28][29][30][31][33][34][35][36][40][41][42] comprised 73.53% of included studies in the present scoping review, which could be classified as of level II-2 if there were multicentric studies, which did not occur. The analyzed controlled clinical trials, 17,20,21,38,39 which could show level of evidence II-1, were also compromised because two systematic reviews of controlled clinical trials 15,37 were uncertain regarding the relation between PD and CAD, as well as demonstrated a high risk of bias of analyzed studies.…”

“…5,32 Even though a wide advantage was found among included papers with favorable opinions, the predominant study design was the cross-sectional. 6,12,14,19,[22][23][24]30,36 F I G U R E 4 Distribution of studies opinions across different publication years. (P = .3302) F I G U R E 5 Distribution of studies opinions and the number of each outcome category (P = .4931)…”

“…It was observed that the variables of the biochemical category were present in 58.82% of studies, 6,[14][15][16][17]20,22,[24][25][26][27]30,31,[34][35][36][37][38][39]41 and, together with clinical variables, 13,15,[19][20][21]28,29,32,33,37,[39][40][41] were the only ones present in all types of opinions. In this regard, the emphasis on the use of inflammatory biomarkers showed that most studies were consistent with the various events that PD and CAD have in common; however, they, alone, do not clearly reflect that a periodontal inflammation is compromising the health of coronary arteries, therefore, with the two diseases coexisting and producing inflammatory biomarkers, one can easily cause an interpretation bias in data analysis of the other.…”