Association between periodontitis and mortality of patients with cardiovascular diseases: A cohort study based on NHANES
Association between periodontitis and mortality of patients with cardiovascular diseases: A cohort study based on NHANES
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DOI：
10.1002/jper.23-0276
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发表时间：
2023-08-03
影响因子：
4.3
通讯作者：
Chen, Qianming
中科院分区：
文献类型：
--
作者：
Chen, Fangman;Song, Yansong;Chen, Qianming
背景牙周炎与心血管疾病（CVD）的关系已被广泛研究，但牙周炎对CVD患者死亡率的影响尚不清楚。本研究旨在阐明牙周炎对CVD患者全因死亡率和死因特异性死亡率的影响。我们纳入了2,135名来自国家健康和营养调查的CVD患者。死亡率数据通过与截至2019年12月31日的国家死亡指数记录相关联来确定。我们使用考克斯比例风险模型计算全因死亡率，使用竞争风险模型计算心血管疾病和癌症死亡率，以估计风险比（HR）和95%置信区间（CI）。进一步进行协变量调整、分层分析和各种敏感性分析，以检验结果的可靠性和稳健性。结果中、重度牙周炎组的全因死亡率明显高于无牙周炎组和轻度牙周炎组（HR：1.25，95% CI：1.02-1.52，P = 0.03）。严重临床依恋丧失的参与者的全因死亡率显著较高（HR：1.07; 95% CI：1.01-1.14; P = 0.01）。然而，不同牙周状况的CVD患者之间没有观察到CVD或癌症死亡率的差异。结论：我们的研究结果从一个大样本的纵向研究表明，显着的，但稍高的全因死亡率在CVD患者中/重度牙周炎比那些没有/轻度牙周炎。
BackgroundThe association between periodontitis and cardiovascular disease (CVD) has been widely explored, but little is known about the effect of periodontitis on the mortality of CVD patients. This study aims to clarify the effect of periodontitis on all-cause and cause-specific mortality of CVD patients. MethodsWe included 2,135 individuals with CVD from the National Health and Nutrition Examination Survey. Mortality data were ascertained by linkage to National Death Index records through 31 December 2019. We used Cox proportional hazards models for all-cause mortality and competing risk models for CVD and cancer mortality to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Further covariate adjustments, stratification analyses, and a variety of sensitivity analyses were conducted to test the reliability and robustness of the results. ResultsThe all-cause mortality in CVD patients with moderate/severe periodontitis was significantly higher than in those with no/mild periodontitis (HR: 1.25; 95% CI: 1.02-1.52; P = 0.03). The all-cause mortality in participants with severe clinical attachment loss was significantly higher (HR: 1.07; 95% CI: 1.01-1.14; P = 0.01). However, no discrepancy in CVD or cancer mortality was observed between CVD patients with different periodontal status. ConclusionsOur findings from a longitudinal study with a large sample indicated significant but slightly higher all-cause mortality in CVD patients with moderate/severe periodontitis than in those with no/mild periodontitis.