Severe Periodontitis Is Associated with Myocardial Infarction in Females

Abstract

The aim of the present study was to test the hypothesis that there is a sex difference in the association between periodontitis (PD) and a first myocardial infarction (MI). The analysis in the case-control study was based on 785 patients (147 females and 638 males) with a first MI and 792 matched controls (147 females and 645 males), screened for cardiovascular risk factors and subjected to a panoramic dental X-ray. Periodontal status was defined by alveolar bone loss and diagnosed as no PD (≥80% remaining alveolar bone), mild to moderate PD (66% to 79%), or severe PD (<66%). Logistic regression was used when analyzing PD as a risk factor for MI, adjusting for age, smoking, diabetes, education, and marital status. The mean age was 64 ± 7 y for females and 62 ± 8 y for males. Severe PD was more common in female patients than female controls (14 vs. 4%, P = 0.005), with an increased risk for severe PD among female patients with a first MI (odds ratio [OR] = 3.92, 95% confidence interval [CI] =1.53 to 10.00, P = 0.005), which remained (OR = 3.72, 95% CI = 1.24 to 11.16, P = 0.005) after adjustments. Male patients had more severe PD (7% vs. 4%; P = 0.005) than male controls and an increased risk for severe PD (OR = 1.88, 95% CI = 1.14 to 3.11, P = 0.005), but this association did not remain following adjustment (OR = 1.67, 95% CI = 0.97 to 2.84, NS). Severe PD was associated with MI in both females and males. After adjustments for relevant confounders, this association did, however, remain only in females. These data underline the importance of considering poor dental health when evaluating cardiovascular risk, especially in females.

Severe and moderate periodontitis are associated with acute myocardial infarction

“…These findings are in agreement with the few previous studies on the topic 5,9 . The more recent study found association between severe periodontitis and myocardial infarction only in females 10 …”

“…The magnitude of the observed association between periodontitis severity levels and AMI varied widely in previous studies (OR = 1.08 to 14.01) 5‐10 in comparison with the association measurements of this study (OR = 1.96 to 3.92). One of the factors that may have influenced on these results is that most previous studies used small sample sizes, reflecting on the accuracy of the association measurements.…”

“…4 However, the studies are still inconclusive concerning the effect of periodontitis severity levels on cardiac outcomes, specifically acute myocardial infarction (AMI). Existing studies are few, [5][6][7][8][9][10] mostly employing different definitions of the exposure severity, thus contributing to the lack of a consensus on this relationship.…”

SOD2 is upregulated in periodontitis to reduce further inflammation progression

“…In contrast, periodontitis can lead to irreversible tissue destruction and extensive alveolar bone loss (Hajishengallis, ). In addition, periodontitis contributes to the progression of other systemic diseases such as diabetes (Polak & Shapira, ; Zheng et al, ), cardiovascular disease (Holmlund, Lampa, & Lind, ; Nordendahl et al, ). Furthermore, periodontitis has recently attracted great attention as a multi‐inflammatory disease among non‐infectious diseases.…”

Atherosclerosis microbiome: upcoming target for vaccine and drug development

“…Similarly in another study, severe periodontitis was more prevalent in female patients than female controls (14% vs. 4%, P = 0.005). An increased risk for severe periodontitis in female patients with a first MI was reported (adjusted OR = 3.72, 95%CI: 1.24 to 11.16, P = 0.005) [37] . Furthermore, multivariate analysis of coronary heart disease (CHD) individuals demonstrated a higher prevalence of oral diseases and lower compliance to oral disease prevention compared to healthy controls.…”