Article

Periodontal disease and risk of myocardial infarction: The role of gender and smoking

Social and Preventive Medicine, SUNY at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA.
European Journal of Epidemiology (Impact Factor: 5.34). 02/2007; 22(10):699-705. DOI: 10.1007/s10654-007-9166-6
Source: PubMed

ABSTRACT

Studies examining the association between periodontal disease and coronary heart disease have shown a consistent but weak to moderate relationship. Limited data have been reported in women and the role of smoking has not been fully clarified.
A population-based case-control study examining the association between periodontal disease (PD) and acute non-fatal myocardial infarction (MI) was conducted in Erie and Niagara counties in Western New York State. Cases (574) were discharged alive from local hospitals with MI diagnosis. Controls (887) were county residents randomly selected from the NY State Department of Motor Vehicles rolls and Health Care Financing Administration files. Periodontal disease was assessed using clinical attachment loss (CAL). Among men (415 cases), the odds ratio (OR) of the association between mean CAL (mm) and MI, adjusting for the effects of age, body mass index (BMI), physical activity, hypertension, cholesterol, diabetes, and total pack-years of cigarette smoking was 1.34 (1.15-1.57). In women (120 cases), the corresponding OR was 2.08 (1.47-2.94). The estimate of this association among non-smokers, also adjusting for age, gender, BMI, physical activity, hypertension, cholesterol, diabetes, and total pack-years of cigarette smoking, was 1.40 (1.06-1.86), while it was 1.49 (1.26-1.77) among smokers.
This study provides evidence of an association between PD and incident MI in both genders. This association appears to be independent from the possible confounding effect of smoking.

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    • "Periodontitis is characterized by gingival inflammation, and periodontopathic bacteria are known to generate immunological inflammatory responses. Periodontitis is a key risk factor for the onset of cardiovascular disease [11] [12] [13]. Recently, we reported the identification of autoantibodies against atria cardiac β 1 -adrenoreceptors (AR), that were able to mimic the effect of an authentic β 1 -AR agonist acting on atria β 1 -AR [14] [15] in the sera of patients with periodontitis. "

    Full-text · Article · Jan 2014 · Pharmacology & Pharmacy
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    • "Periodontitis is characterized by gingival inflammation and periodontopathic bacteria generate immunological inflammatory responses . Periodontitis is a key risk factor for the onset of cardiovascular disease [24] [25] [26]. Recently, we reported that in the sera of periodontitis patients we found autoantibodies against atria cardiac β 1 -AR that were able to mimic the effect of an authentic β 1 -AR agonist acting on atria β 1 -AR [5] [6]. "
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    ABSTRACT: An anti-β(1)-adrenergic antibody from the sera of periodontitis patients (anti-β(1)-AR IgG) against the second extracellular loop of the human β(1)-adrenoceptor (β(1)-AR) has been shown to cause rat atria apoptosis. The anti-β(1)-AR IgG binds and activates atria β(1)-AR, increasing the intracellular calcium concentration, which, in turn, activates caspases-3, -8, and -9. The β(1)-AR and the post-receptor activation of calcium/calmodulin (CaM) lead to increased inducible nitric oxide synthase (iNOS) activity, with an increase in cyclic GMP (cGMP) accumulation as well as increased JNK phosphorylation and cyclic AMP (cAMP) production. We also observed an apoptotic effect of anti-β(1)-AR IgG, with increased generation of PGE(2). Comparatively, xamoterol, an authentic β(1)-AR agonist, mimicked the autoantibody effect on rat atria β(1)-AR apoptosis. Our results suggest that autoantibodies from the sera of periodontitis patients bind and interact with rat atria β(1)-AR, provoking apoptosis. This implicates a series of modulatory cardiac signaling events that could alter normal heart function and may occur with chronic stimulation of the atria β(1)-AR, which could lead to heart failure. These results suggest an important link between periodontitis and cardiovascular disease.
    Full-text · Article · Oct 2012 · International immunopharmacology
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    • "The evidence has proved that severe periodontitis plays a role in the initiation and development of atherosclerosis disease [3]. Researcher has showed poor periodontal status is an important risk factor for cardiovascular diseases and the consistent relationship between pocket depth and incident myocardial infarction [4]. Periodontal bleeding per se is the indicator of bacteraemia and gingival inflammation is correlated positively with the prevalence of bacteraemia [5]. "
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    ABSTRACT: Objective: Periodontitis and atherosclerosis diseases are chronic inflammatory disorders which are highly prevalent in populations. Nonsurgical periodontal intervention belongs to the initial therapy strategy to periodontal diseases. Periodontal pathogen can enter into blood stream through the ulceration epithelial resulting in bacteraemia when periodontitis is severe. The objective is to investigate the relationship be-tween periodontitis and atherosclerosis diseases, and the influence of nonsurgical periodontal intervention on atheroma and atherosclerosis diseases. Methods: This study reviewed and analyzed the papers which published in the world associated with periodontitis or periodontal intervention on atherosclerosis dis-eases. Results: Periodontitis and periodontal infec-tious are important risk factors for atherosclerotic diseases. Much evidence has proved the durative se-vere periodontitis can result in bacteraemia and sys-temic inflammation, elevated C-response protein in serum, gingival microcirculation changed, periodon-tal microorganism reproduced, and endothelial dys-function and endocarditis. Nonsurgical periodontal intervention can remove the pathogenesis bacteria and calculus to recover periodontal health. Effective periodontal therapy can reduce bacteraemia and stop the hurt to vessels. Nonsurgical periodontal therapy may interfere periodontal bacteria, inhibit inflamma-tion response and C-response protein, improving gin-gival microcirculation and vessel epithelial function to prevent atherosclerosis. Conclusion: Nonsurgical periodontal intervention can improve or decrease the rate of atherosclerotic disease by interfere the severe periodontitis. The detailed mechanism of periodontal intervention on atheroma and atherosclerotic disease is still need to be explored.
    Preview · Article · Jan 2012 · Advances in Bioscience and Biotechnology
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