Abstract
To evaluate whether estimates of risk of future cardiovascular events and death and established or unknown diabetes are significantly associated with calcified carotid artery atheromas (CCAAs) on panoramic radiographs (PRs). The main focus was on men and women without previous myocardial infarction (MI). The PAROKRANK (Periodontitis and its Relation to Coronary Artery Disease) study included patients with a first MI and matched control subjects. In this substudy, 738 patients (138 women) and 744 control subjects (144 women) with available PRs were assessed for CCAA. Cardiovascular risk estimates were determined according to the Framingham Risk Score (FRS) and Systematic COronary Risk Evaluation (SCORE). Established and previously unknown diabetes was also determined. CCAA was detected on PRs in 206 control subjects (28%) and 251 patients (34%). FRS was significantly associated with CCAA among control subjects (P=.04) and patients (P=.001). SCORE was associated with CCAA among control subjects (P < .01) but not patients (P=.07). Among men, FRS and SCORE were associated with CCAA in both control subjects and patients. Diabetes was not significantly associated with CCAA after adjustments. Elevated cardiovascular risk scores were associated with CCAA on PRs among control subjects. Diabetes was not independently associated with CCAA, possibly owing to selection bias.
Highlights
In the sex-stratified analysis of the patients with recent myocardial infarction (MI), we found that the moderate, high, and very highÀrisk Framingham Risk Score (FRS) categories among men were significantly associated with calcified carotid artery atheromas (CCAAs) (P .05), as were slight, moderate, and high risk among women (P .04)
The main result of this investigation was that a higher cardiovascular risk profile was significantly associated with incidental findings of CCAA based on panoramic radiographs (PRs) among control subjects, indicating that these individuals carried an increased risk of cardiovascular events or death compared with control subjects without CCAA
CCAA seen on PRs was associated with an increased estimated risk of future cardiovascular events and death according to FRS and Systematic COronary Risk Evaluation (SCORE) among control subjects without previous MI, in particular among male control subjects
Summary
Study population The present study population was based on the study population of the Swedish multicenter PAROKRANK study, which was conducted at 17 hospitals between 2010 and 2014. The population comprised 1610 individuals with a mean age of 62§8 years, including 805 patients with a first MI (151 women) and 805 matched control subjects with no history of MI (151 women), as described in detail elsewhere.[22] The patients were included on the basis of a diagnosis of acute MI as defined by SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies).[23] Exclusion criteria were previous MI or previous heart valve replacement, age >75 years, residence outside the treating center catchment areas, severe disease that could interfere with participation and dental investigations, and language or cognitive issues. When baseline characteristics between excluded and included participants were compared, there were no significant differences
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