Abstract WMP103: Serum Igg Titers of Periodontal Pathogens Predict Hemorrhage Growth and 3-Month Outcome in Patients With Cerebral Hemorrhage

Abstract

Introduction: It has been reported that stroke is associated with periodontal disease, which is caused by many kinds of pathogens; however, the influence of periodontal disease on cerebral hemorrhage and its clinical course have not been investigated. Thus, we examined the association of the serum IgG titer of periodontal pathogens with hemorrhage growth and 3-month outcome. Methods: We consecutively enrolled 115 patients with acute cerebral hemorrhage (44 females, 71.3±13.1 years). The serum IgG titers of 16 periodontal pathogens ( P. gingivalis [5 strains], A. actinomycetemcomitans [3 strains], P . intermedia , P . nigrescens , F . nucleatum [ 2 strains], T. denticola , T. forsythensis , C. rectus , E. corrodens ) were evaluated using the ELISA method. Significant hematoma growth was defined as an increase in volume of >33% or an absolute increase of volume of >12.5 mL. A poor outcome was defined as a 3 or higher on the modified Rankin Scale. In the multivariate analysis, we used the following factors for adjustment: age, sex, BMI, NIHSS score on admission, drinking and smoking habits, comorbidities (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, peripheral artery disease, and chronic heart failure), and CRP levels. Results: Hemorrhage growth was found in 13 patients (11.3%). On univariate analysis, hemorrhage growth was associated with NIHSS score, diabetes mellitus, chronic heart failure, and IgG titers of A. actinomycetemcomitans SUNY 67 . Multivariate analysis revealed that this IgG titer was independently associated with hemorrhage growth (odds ratio 3.18, 95% CI 1.13-8.95). Notably, the IgG titer of F. nucleatum10953 but not A. actinomycetemcomitans SUNY 67 was associated with a poor 3-month outcome (odds ratio 6.11, 95% CI 1.51-31.21). Conclusions: Higher serum IgG titer of A. actinomycetemcomitans SUNY 67 was an independent factor for predicting hemorrhage growth in patients with cerebral hemorrhage. Higher serum IgG titer of F. nucleatum10953 was associated with a poor outcome, which suggests the systemic negative impact on stroke patients apart from hemorrhage growth.