Associations among Periodontitis, Calcified Carotid Artery Atheromas, and Risk of Myocardial Infarction
Associations among Periodontitis, Calcified Carotid Artery Atheromas, and Risk of Myocardial Infarction
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DOI：
10.1177/0022034519885362
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发表时间：
2019-11-08
影响因子：
7.6
通讯作者：
Levring Jaghagen, E.
中科院分区：
文献类型：
--
作者：
Gustafsson, N.;Ahlqvist, J.;Levring Jaghagen, E.
心血管疾病是发病率和过早死亡的常见原因。如果及早识别危险因素，心血管疾病是可以预防的。在全景X线片中发现的钙化性颈动脉粥样硬化(CCaaS)和牙周炎都与心血管疾病的风险增加有关。这项病例对照研究的目的是：1)研究牙周炎与全景X线片中发现的CCAA之间的关系；2)确定CCAA合并牙周炎后发生心肌梗死的风险。我们评估了从PAROKRANK研究(牙周炎及其与冠状动脉疾病的关系)招募的1482名患有牙周炎和CCaS的参与者(738例和744名对照)。参与者接受了包括颈动脉区域在内的全景X光片检查。在696例患者和696名年龄、性别和居住地区匹配的对照组中，评估了心肌梗死与牙周炎合并CCAA的相关性。对牙周炎进行放射学评估(作为骨丢失程度)和临床牙周病指数评分(来自临床和放射学评估)。我们发现CCAA与临床牙周病指数评分相关(优势比[OR]，1.51；95%CI，1.09至2.10；P=0.02)和对照组(OR，1.70；95%CI，1.22至2.38；P<；0.01)，但CCAA与骨质丢失程度无关。在多变量模型中，根据骨质丢失程度评估，心肌梗死与CCAA合并牙周炎有关(OR，1.75；95%CI，1.11至2.74；P=0.01)。当队列按性别分层时，只有男性显示心肌梗死与CCAA合并牙周炎显著相关。临床诊断为牙周炎的参与者在全景X线片中表现为CCAA的频率高于非牙周炎的参与者，而与最近是否存在心肌梗死无关。与单独患有牙周炎和CCAA的参与者相比，患有牙周炎和CCAA的参与者发生心肌梗死的风险更高。这些发现表明，牙科护理中的患者可能受益于牙医评估CCAA的全景X光片--特别是没有接受过任何心血管疾病预防措施的牙周炎患者。
Cardiovascular disease is a common cause of morbidity and premature mortality. Cardiovascular disease can be prevented when risk factors are identified early. Calcified carotid artery atheromas (CCAAs), detected in panoramic radiographs, and periodontitis have both been associated with increased risk of cardiovascular disease. This case-control study aimed to 1) investigate associations between periodontitis and CCAA detected in panoramic radiographs and 2) determine the risk of future myocardial infarctions due to CCAA combined with periodontitis. We evaluated 1,482 participants (738 cases and 744 controls) with periodontitis and CCAAs recruited from the PAROKRANK study (Periodontitis and Its Relation to Coronary Artery Disease). Participants were examined with panoramic radiographs, including the carotid regions. Associations between myocardial infarction and periodontitis combined with CCAA were evaluated in 696 cases and 696 age-, sex-, and residential area-matched controls. Periodontitis was evaluated radiographically (as degree of bone loss) and with a clinical periodontal disease index score (from clinical and radiographic assessments). We found associations between CCAA and clinical periodontal disease index score among cases (odds ratio [OR], 1.51; 95% CI, 1.09 to 2.10; P = 0.02) and controls (OR, 1.70; 95% CI, 1.22 to 2.38; P < 0.01), although not between CCAA and the degree of bone loss. In a multivariable model, myocardial infarction was associated with CCAA combined with periodontitis, as assessed by degree of bone loss (OR, 1.75; 95% CI, 1.11 to 2.74; P = 0.01). When the cohort was stratified by sex, only men showed a significant association between myocardial infarction and CCAA combined with periodontitis. Participants with clinically diagnosed periodontitis exhibited CCAA in panoramic radiographs more often than those without periodontitis, irrespective of the presence of a recent myocardial infarction. Participants with combined periodontitis and CCAA had a higher risk of having had myocardial infarction as compared with participants with either condition alone. These findings implied that patients in dental care might benefit from dentists assessing panoramic radiographs for CCAA-particularly, patients with periodontitis who have not received any preventive measures for cardiovascular disease.