Periodontal disease and risk of subsequent cardiovascular disease in US male physicians
Periodontal disease and risk of subsequent cardiovascular disease in US male physicians
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DOI：
10.1016/s0735-1097(00)01130-x
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发表时间：
2001-02-01
影响因子：
24
通讯作者：
Christen, WG
中科院分区：
文献类型：
--
作者：
Howell, TH;Ridker, PM;Christen, WG
目的我们试图前瞻性地评估自我报告的牙周病是否与大量男性医生随后患心血管疾病的风险相关。背景牙周病是细菌感染和慢性炎症复杂相互作用的结果，已被认为是心血管疾病的预测因子。方法医师健康研究I是一项随机、双盲、安慰剂对照试验阿司匹林和β-胡萝卜素在22，071美国男性医生。共有22，037名医生提供了自我报告的存在或不存在的牙周病在研究进入，并被列入本analysis.Results共有2，653名医生在基线牙周病的个人病史。在平均12.3个月的随访中，有797例非致命性心肌梗死，631例非致命性中风和614例心血管死亡。因此，对于每个终点，该研究有>90%的把握度检测到临床上重要的风险增加50%。在校正年龄和治疗分配的考克斯比例风险回归分析中，基线时报告牙周病的医生发生非致死性心肌梗死的相对风险（RR）略有升高，但无统计学意义，（RR，1.12; 95%置信区间[CI]，0.92至1.36），非致死性卒中（RR，1.10; CI，0.88至1.37）和心血管死亡（RR，1.20; CI，0.97至1.49）。所有重要心血管事件（首次发生非致死性心肌梗死、非致死性卒中或心血管死亡）的联合终点的相对风险为1.13（CI，0.99 - 1.28）。调整其他心血管危险因素后，RR均衰减和nonsignificant.Conclusions这些前瞻性数据表明，自我报告的牙周疾病是不是一个独立的预测随后的心血管疾病在中年到老年男性。(C)2001年，美国心脏病学会。
Objectives We sought to prospectively assess whether self-reported periodontal disease is associated with subsequent risk of cardiovascular disease in a large population of male physicians.Background Periodontal disease, the result of a complex interplay of bacterial infection and chronic inflammation, has been suggested to be a predictor of cardiovascular disease.Methods Physicians' Health Study I was a randomized, double-blind, placebo-controlled trial of aspirin and beta-carotene in 22,071 U.S. male physicians. A total of 22,037 physicians provided self-reports of presence or absence of periodontal disease at study entry and were included in this analysis.Results A total of 2,653 physicians reported a personal history of periodontal disease at baseline. During an average of 12.3 pears of follow-up, there were 797 nonfatal myocardial infarctions, 631 nonfatal strokes and 614 cardiovascular deaths. Thus, for each end point, the study had >90% power to detect a clinically important increased risk of 50%. In Cox proportional hazards regression analysis adjusted for age and treatment assignment, physicians who reported periodontal disease at baseline had slightly elevated, but statistically nonsignificant, relative risks (RR) of nonfatal myocardial infarction, (RR, 1.12; 95% confidence interval [CI], 0.92 to 1.36), nonfatal stroke (RR, 1.10; CI, 0.88 to 1.37) and cardiovascular death (RR, 1.20; CI, 0.97 to 1.49). Relative risk for a combined end point of all important cardiovascular events (first occurrence of nonfatal myocardial infarction, nonfatal stroke or cardiovascular death) was 1.13 (CI, 0.99 to 1.28). After adjustment for other cardiovascular risk factors, RRs were all attenuated and nonsignificant.Conclusions These prospective data suggest that self-reported periodontal disease is not an independent predictor of subsequent cardiovascular disease in middle-aged to elderly men. (C) 2001 by the American College of Cardiology.