Chronic Periodontitis Could Increase Cardiovascular Events: A Ten Years Follow-Up Study

Abstract

Background: Chronic periodontitis (CP) could be considered to have the causal relationship with cardiovascular disease (CVD). The aim of this study is to investigate the causal association between CP and CVD using representative health insurance cohort in Korea. Methods: A retrospective cohort study was performed to test the hypothesis that CP increased CVD incidence among Koreans who had no history of AMI (acute myocardial infarction) or ST (stroke) from 2002 to 2013, using the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). A total of 298,128 participants were selected and followed up for ten years from this cohort. Multivariable cox regression analysis was applied to estimate adjusted hazard ratio (aHR). Findings: Our data showed that CP was significantly associated with higher incidence of AMI and ST. Compared with healthy participants, those with severe CP had higher incidence by 11% for AMI (aHR, 1.11 [95% CI 1.02-1.20]), by 4% for ST (aHR, 1.04 [95% confidence interval (CI) 1.01-1.07]), and by 4% for CVD (aHR, 1.04 [95% CI, 1.01-1.07]). The association for AMI and CVD was positively modified in females and participants aged 40-59 years, while the association for ST was modified in females but not in participants aged 40-59 years only in ST. CP increased total CVD events by 1.6% among Korean. Interpretation: Our data confirmed that CP could increase the event of CVD such as AMI and ST. The prevention and management of CP could be worth in clinical practice to prevent CVD. Funding Statement: This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science and ICT, Korea (NRF2017M3A9B6062986). Declaration of Interests: The authors state: None exist. Ethics Approval Statement: The Institutional Review Board (IRB) at the Seoul National University Hospital, which is in compliance with the Declaration of Helsinki, approved this study (IRB number E-1801-019- 912). This study used the Korean National Health Insurance Service database (NHIS-2017-2-459).