Periodontitis and risk of prevalent and incident coronary heart disease events.

Lewis Winning,Frank Kee,Christopher C Patterson,Katie Linden,Alun Evans,John Yarnel,Pascal P Mckeown,Gerard J Linden

doi:10.1111/jcpe.13377

Abstract

To investigate periodontitis as a risk factor for prevalent and incident coronary heart disease (CHD) in a group of middle-aged men from Northern Ireland. A representative sample of 1400 dentate men had a comprehensive periodontal examination between 2001 and 2003. Prevalent and incident CHD events were validated by independent cardiologists. Logistic regression was used to assess the cross-sectional relationship between periodontitis and prevalent CHD and Cox's proportional hazards analysis to assess the longitudinal relationship between periodontitis and incident CHD. The mean age of the men at baseline was 63.7 (SD 3.0)years. Of the 1400 men examined, 126 (9%) had prevalent CHD. After adjusting for confounding variables, men with highest mean CAL (Q4) had an odds ratio of 2.15 (95% CI 1.15-4.02), p=0.02 for prevalent CHD in comparison to men with the lowest CAL (Q1). During a median follow-up of 12.7years, 137 (10.8%) of the 1274 men free of CHD at baseline had an incident CHD event. After adjusting for confounding variables, the hazard ratio for incident CHD in men in Q4 versus Q1 CAL categories was 1.36 (95% CI 0.81-2.29), p=0.24. In this group of dentate men, periodontitis was associated with prevalent CHD. However, there was no association with incident CHD.

Highlights

Coronary heart disease (CHD) remains the global leading cause of death and morbidity (Lozano et al, 2012)
Principal findings: This longitudinal cohort study found that in a group of dentate 58- to 72-year-old men from Northern Ireland, periodontitis was associated with prevalent coronary heart disease (CHD) but was not associated with incident CHD over a 12.7-year observation period
This study suggests periodontitis may not be an independent risk factor for incident CHD in older aged persons

Summary

Introduction

Coronary heart disease (CHD) remains the global leading cause of death and morbidity (Lozano et al, 2012). Epidemiological studies have helped identify a range of what are considered classic risk factors for cardiovascular disease (including CHD) such as age, smoking, hypertension and hypercholesteraemia (Yusuf et al, 2001). Identification of such risk factors has led to the development of riskprediction algorithms and established cardiovascular risk models for men and women (Lloyd-Jones Donald, 2010). These conventional risk factors, cannot fully explain excess cardiovascular risk, with at least 25% of all future events occurring in individuals with only one of the classical risk factors (Vilahur et al, 2014)

Methods

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Discussion

Conclusion