Porphyromonas gingivalis (Pg) a possible link between impaired oral health and acute myocardial infarction

Holmlund, Anders; M, Hedin; Pussinen, Pirkko J.; Lerner, Ulf H.; Lind, Lars

doi:10.1016/j.ijcard.2009.10.034

Cited by 38 publications

(48 citation statements)

References 45 publications

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“…MI incidence correlates with the number of pockets > 4 mm deep, bleeding sites after probing, and severity of tooth loss, even after adjustment for known cardiovascular risk factors (e.g., smoking, diabetes, or hypertension) (4). Antibodies against the periodontal pathogen Porphyromonas gingivalis are also elevated in MI patients (4), and heart-failure patients exhibit increased bone turnover markers in circulation and a more advanced PD phenotype compared with healthy control patients (6). In addition, severe periodontitis is more prevalent among post-MI heart-failure patients than dilated cardiomyopathy-induced heart-failure patients (5).…”

Section: Introductionmentioning

confidence: 98%

“…Periodontal disease (PD) is associated with adverse wound healing in response to injury across organ systems, including poor cardiac responses to myocardial infarction (MI) (1)(2)(3)(4)(5)(6). MI incidence correlates with the number of pockets > 4 mm deep, bleeding sites after probing, and severity of tooth loss, even after adjustment for known cardiovascular risk factors (e.g., smoking, diabetes, or hypertension) (4).…”

Section: Introductionmentioning

confidence: 99%

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Periodontal-induced chronic inflammation triggers macrophage secretion of Ccl12 to inhibit fibroblast-mediated cardiac wound healing

DeLeon‐Pennell

Iyer²,

Ero³

et al. 2017

JCI Insight

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Periodontal-induced chronic inflammation triggers macrophage secretion of Ccl12 to inhibit fibroblast-mediated cardiac wound healing

DeLeon‐Pennell

Iyer²,

Ero³

et al. 2017

JCI Insight

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“…For example, while many of the case-control studies employed matching for some factors in the design, the need to address the matching in the analysis appropriately was ignored in some studies (Persson et al 2003). We also had to exclude some studies in which investigators had included more than one measure of PD simultaneously in to the same regression model, rendering the resulting estimates not readily interpretable (Starkhammar Johansson et al 2008, Pradeep et al 2010, Holmlund et al 2011.…”

Section: Discussionmentioning

confidence: 99%

The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease

Dietrich

Sharma

Walter

et al. 2013

Journal of Periodontology

178

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The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. AbstractObjectives: The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease. Methods: Systematic review of cohort and case-control studies on the association of clinically or radiographically diagnosed PD and ACVD. Results: Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events. Conclusions: There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events. The possible association between periodontitis (PD) and atherosclerotic cardiovascular disease (ACVD) has received much attention over the past two decades, and a significant number of epidemiological studies have been conducted during this time. The evidence has been systematically reviewed several times during that period (Hujoel 2002, Janket et al. 2003, Khader et al. 2004, Bahekar et al. 2007, Humphrey et al. 2008, Blaizot et al. 2009). Most recently, a comprehensive review was performed by an American Heart Association (AHA) working group (Lockhart et al. 2012), which concluded that "periodontal disease is associated with atherosclerotic Conflict of interest and source of funding statementThe authors declare no conflict of interest. The workshop was funded by an unrestricted educational grant from Colgate-Palmolive to the European Federation of Periodontology and the American Academy of Periodontology.© 2013 European Federation of Periodontology and American Academy of Periodontology S70 vascular disease independent of known confounders". It further concluded that there was no evidence for a causal link and that, therefore, "statements that imply a causative association between periodontal disease and specific atherosclerotic vascular disease events […] are unwarranted". The review further highlighted several research gaps and methodological issues relevant to further research, including the need for uniform criteria for PD measures and case definitions but mainly with regard to the need of well-designed controlled interventional studies w...

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“…After their exclusion, 38 articles were selected for further full-text review. Eventually, 17 studies (Emingil et al, 2000; Rutger Persson et al, 2003; Deliargyris et al, 2004; Renvert et al, 2004; Cueto et al, 2005; Andriankaja et al, 2006, 2007; Kaisare et al, 2007; Stein et al, 2009; Willershausen et al, 2009, 2014; Holmlund et al, 2011; Kodovazenitis et al, 2011, 2014; Khosravi Samani et al, 2013; Wożakowska-Kapłon et al, 2013; Rydén et al, 2016) were included in our meta-analysis. A flow diagram of search process and results is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Association between Myocardial Infarction and Periodontitis: A Meta-Analysis of Case-Control Studies

et al. 2016

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Background and Objective: Many clinical researches have been carried out to investigate the relationship between myocardial infarction (MI) and periodontitis. Despite most of them indicated that the periodontitis may be associated with an increased risk of MI, the findings and study types of these studies have been inconsistent. The goal of this meta-analysis was to critically assess the strength of the association between MI and periodontitis in case-control studies.Methods: PubMed and the Cochrane Library were searched for eligible case-control studies reporting relevant parameters that compared periodontal status between MI and control subjects. The odds ratios (ORs) and 95% confidence intervals (CIs) from each study were pooled to estimate the strength of the association between MI and periodontitis. The mean differences and 95% CIs for periodontal-related parameters were calculated to determine their overall effects.Results: Seventeen studies including a total of 3456 MI patients and 3875 non-MI control subjects were included. The pooled OR for the association between MI and periodontitis was 2.531 (95% CI: 1.927–3.324). The mean differences (95% CIs) for clinical attachment loss, probing depth, bleeding on probing, plaque index, and the number of missing teeth were 1.000 (0.726–1.247), 1.209 (0.538–1.880), 0.342 (0.129–0.555), 0.383 (0.205–0.560), and 4.122 (2.012–6.232), respectively.Conclusion: With the current evidence, the results support the presence of a significant association between MI and periodontitis. Moreover, MI patients had worse periodontal and oral hygiene status and fewer teeth than did control subjects. More high-quality and well-designed studies focusing on the casual relationship between MI and periodontitis should be conducted in the future.

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Porphyromonas gingivalis (Pg) a possible link between impaired oral health and acute myocardial infarction

Cited by 38 publications

References 45 publications

Periodontal-induced chronic inflammation triggers macrophage secretion of Ccl12 to inhibit fibroblast-mediated cardiac wound healing

Periodontal-induced chronic inflammation triggers macrophage secretion of Ccl12 to inhibit fibroblast-mediated cardiac wound healing

The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease

Association between Myocardial Infarction and Periodontitis: A Meta-Analysis of Case-Control Studies

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