Severe Periodontal Disease Increases risk of Acute Myocardial Infarction and Stroke: Study

The study is published in the Journal of Dental Research.

H.J. Cho and colleagues from the Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea carried out the present research to evaluate the causal association of periodontal disease with acute myocardial infarction (AMI) and stroke, after controlling for various confounders among the Korean population.

A retrospective cohort study using the National Health Insurance Service–National Health Screening Cohort (NHIS-HEALS) was performed in the Republic of Korea. A total of 298,128 participants with no history of AMI or stroke were followed up for 10 years.

AMI and stroke were defined by a diagnosis using the International Classification of Diseases, 10th Revision (ICD-10) guideline. Periodontal condition was classified into 3 groups (healthy, moderate periodontal disease, severe periodontal disease [SPD]) using the combination of ICD codes, treatment codes in the NHIS, and recommendation of periodontal treatment by the dentists in HEALS.

Various confounders, such as sociodemographic, behavioral, systemic, and oral health factors, including hypercholesterolemia, were considered. Multivariable Cox regression analysis was applied to estimate adjusted incidence rate ratio (adjusted hazard ratio [aHR]) based on person-year of periodontal condition for AMI, stroke, and nonfatal major adverse cardiovascular events (MACEs) encompassing AMI or stroke controlling for various confounders.

Stratified analyses according to age group, sex, and toothbrushing frequency were also performed.

The following findings were found out-

1. After controlling for various confounders, participants with SPD compared with non-SPD participants had a higher incidence by 11% for AMI (aHR, 1.11; 95% confidence interval [CI], 1.02–1.20), by 3.5% for stroke (aHR, 1.035; 95% CI, 1.01–1.07), and by 4.1% for MACEs (aHR, 1.04; 95% CI, 1.01–1.07).

2. The association of SPD with AMI and MACE was highly modified in females and adults aged 40 to 59 y.

3. In the total Korean population, SPD increased total AMI events by 4.3%, total stroke events by 1.4%, and the total MACEs by 1.6%.

Hence, the authors concluded that "SPD was causally associated with the new events of AMI and stroke."