Abstract
ObjectivesThe aim of this study was to characterize biological changes following dental extractions in patients with and without coronary artery disease (CAD).Materials and methodsForty-five patients (36 males and 9 females) referred for dental extraction underwent treatment and provided blood samples before, immediately after, and 24 h after the procedure. A broad array of biomarkers was employed to assess myocardial injury (highly sensitive troponin T, hs-TnT), bacterial burden (LPS endotoxin activity), and systemic inflammation (CRP, fibrinogen, IFN-γ, IL-1β, IL-6, IL-8, IL-10, IL-12, and TNF-α).ResultsDental extraction in patients with and without CAD was associated with rises in hs-TnT (p = 0.013), hs-CRP (p < 0.001), fibrinogen (p = 0.005), endotoxin activity (p < 0.001), IFN-γ (p < 0.001), IL-6 (p < 0.001), IL-8 (p = 0.011), and IL-12 (p < 0.001) at 24 h compared with immediately post procedure. Changes in systemic inflammation and endotoxin activity were more evident in those with hs-TnT rise.ConclusionsSimple dental extractions may cause mild increase in hs-TnT, indicating minor myocardial injury in both patients with and without CAD. Acute systemic inflammation and endotoxemia could represent a possible link between invasive dental treatment and increased risk of acute cardiovascular events. These findings indicate that invasive dental treatment (as simple as a single dental extraction) may impact negatively on clinical outcomes in dental patients, especially those with CAD.
Highlights
Inflammation plays a major role in the pathogenesis of atherosclerosis and its complications.[1]
Non-fasting blood samples were obtained by a clean venipuncture The coronary artery disease (CAD) group comprised 28 patients (25 men and 3 women) from the antecubital fossa and with minimal stasis, before and 15 with an age range of 41–91 years and the non-CAD group min and 24 h after the dental procedures
There were no significant statistical differences between patients with and without CAD in terms of patient’s characteristics, associated diseases/risk factors, dental procedure-related variables, and medications used by the Biomarkers of myocardial injury
Summary
Inflammation plays a major role in the pathogenesis of atherosclerosis and its complications.[1]. Especially in the form of periodontitis, is known to cause an elevation of inflammatory biomarkers, and its treatment has been linked with both acute and chronic changes in systemic inflammation in otherwise healthy individuals.[4] A recent case series reported an increased risk of mortality, due to vascular events in patients with CAD following dental treatment.[5]. Epidemiologic evidence links invasive dental procedures with an increased risk of vascular events, but the mechanisms that underlie these trends remain poorly understood.[6] The acute influence of invasive dental procedures, such as exodontia upon CAD, and the possible mechanisms involved, have not been described in great detail
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