Asymptotic dental score and prevalent coronary heart disease
Asymptotic dental score and prevalent coronary heart disease
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DOI：
10.1161/01.cir.0000118497.44961.1e
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发表时间：
2004-03-09
期刊：
影响因子：
37.8
通讯作者：
Jones, JA
中科院分区：
文献类型：
--
作者：
Janket, SJ;Qvarnström, M;Jones, JA
背景-口腔感染已被假定产生细胞因子，可能有助于冠心病（CHD）的发病机制。我们假设，通过估计联合生产的炎症介质归因于几个口腔病理，我们可能能够解释CHD与更好的precision.Methods和结果-共256个连续的芬兰心脏病患者从库奥皮奥大学医院血管造影证实CHD和250年龄，性别和居住匹配的非心脏病患者（对照组）被招募。所有牙科因素预计产生炎症介质，包括冠周炎，龋齿，牙齿状态，根残，牙龈炎，进行了检查，并制定了一个渐进的牙科评分（ADS）的逻辑回归分析与适当的加权方案，根据似然比。我们通过将ADS与总牙科指数进行比较，并检查ADS是否与已知的冠心病预测因子相关，来验证ADS的解释能力。包括ADS、C-反应蛋白、HDL和纤维蛋白原的模型提供的解释能力等于或超过Fragrance心脏评分（C统计量= 0.82 vs 0.80）。当ADS从这个模型中删除，C-统计量下降到0.77，这表明，ADS是一个显着的贡献者的解释能力的逻辑model.Conclusions - ADS可能是有用的预筛选工具，以促进积极的心脏评估个人没有明显的症状冠心病。然而，需要额外的前瞻性研究来验证使用口腔健康评分作为冠心病事件的预测因子。
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 statistic = 0.82 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.