ST-ELEVATION MYOCARDIAL INFARCTION IS OFTEN DUE TO INFECTION WITH PATHOGENIC BACTERIA ASSOCIATED WITH PERIODONTAL DISEASE

Abstract

Methods: Our aim was to study the possible role of bacteria in patients with acute MI. Consecutive patients with ST-elevation MI treated with primary PCI and macroscopic thrombus aspirated during the intervention were included. Control blood sample was obtained for every patient from the arterial sheath at the end of the intervention. Ortopantomographic analyses have been performed in a subgroup of patients. Results: This preliminary analysis includes 22 patients. The patients were treated within 24 hours from symptom onset. The culprit vessel was LAD in 45%, LCX in 32% and RCA in 23%. Final TIMI3 low was achieved in 91%. The macroscopic aspirate contained red thrombus in 77%, mixed thrombi in 14% and white thrombus in 9%. Detailed DNA analysis of the thrombi revealed common oral pathogens (mainly mitis-group streptococci) in 19 (86%) of the patients. Other common bacteria (for example Chl. Pneumoniae) were not found. Control blood samples showed no evidence of ongoing bacteremia or contamination. Conclusions: Periodontal pathogens are often found in coronary thrombi of patients with acute MI. This suggests that periodontal bacteria may have a direct causative role in triggering acute MI. Patient recruitment and data analyses are ongoing and we expect to present data involving approximately 100 patients at the ACC.