Periodontal disease and risk of myocardial infarction: the role of gender and smoking (original) (raw)

Abstract

Background: 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. Methods/Results: 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. Conclusions: 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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References

  1. Herzberg MC, MacFarlane GD, Gong K, Armstrong NN, Witt AR, Eroclspm PR, Meyer MW. The platelet interactivity phenotype of Streptococcus sanguis influences the course of experimental endocarditis. Infect Immun 1992;60:4809–18.
    PubMed CAS Google Scholar
  2. Herzberg MC, MacFarlane GD, Liu P, Erickson PR. The platelet as an inflammatory cell in periodontal diseases: interactions with Porphyromonas gingivalis. In: Genco RJ, Hamada S, Lehner T, McGhee JR, Mergenhagen SE, editors. Molecular pathogenesis of periodontal disease. Washington, DC: American Society for Microbiology; 1994. p. 247.
    Google Scholar
  3. Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identification of periodontal pathogens in atheromatous plaques. J Periodontol 2000;71:1554–60.
    Article PubMed CAS Google Scholar
  4. Mattila KJ, Valle MS, Nieminen MS, Valtonen VV, Hietaniemi KL. Dental infections and coronary atherosclerosis. Atherosclerosis 1993;103:205–11.
    Article PubMed CAS Google Scholar
  5. Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesaniemi YA, Syrjala SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. Br Med J 1989;298:779–82.
    CAS Google Scholar
  6. Mattila KJ, Valtonen VV, Nieminen MS, Huttunen JK. Dental infection and the risk of new coronary events: prospective study of patients with documented coronary heart disease. Clin Infect Dis 1995;20:588–92.
    PubMed CAS Google Scholar
  7. Emingil G, Buduneli E, Aliyev A, Atilla G. Association between periodontal disease and acute myocardial infarction. J Periodontol 2000;71:1882–6.
    Article PubMed CAS Google Scholar
  8. Joshipura KJ, Rimm EB, Douglass CW, Trichopoulos D, Ascherio A, Willett WC. Poor oral health and coronary heart disease. J Dent Res 1996;75:1631–6.
    Article PubMed CAS Google Scholar
  9. Morrison HI, Ellison LF, Taylor GW. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7–11.
    PubMed CAS Google Scholar
  10. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol 1996;67 Suppl 10:1123–37.
    PubMed CAS Google Scholar
  11. Mattila KJ, Asikainen S, Wolf J, Jousimies-Somer H, Valtonen V, Nieminen M. Age, dental infections, and coronary heart disease. J Dent Res 2000;79:756–60.
    PubMed CAS Google Scholar
  12. Danesh J. Coronary heart disease, Helicobacter pylori, dental disease, Chlamydia pneumoniae, and cytomegalovirus: meta-analyses of prospective studies. Am Heart J 1999;138(5 Pt 2):S434–7.
    Article PubMed CAS Google Scholar
  13. Beaglehole R, Stewart AW, Butler M. Comparability of old and new World Health Organization criteria for definite myocardial infarction. Int J Epidemiol 1987;16:373–6.
    Article PubMed CAS Google Scholar
  14. International Classification of Diseases. 9th revisions. Clinical modification. 4th ed. 1995;198–9.
  15. Trevisan M, Dorn J, Falkner K, Russell M, Ram M, Muti P, Freudenheim JL, Nochajaski T, Kathy H. Drinking pattern and risk of non-fatal myocardial infarction: a population-based case-control study. Addiction 2004;99(3):313–22.
    Article PubMed Google Scholar
  16. Gibbs CH, Hirschfeld JW, Lee JG, Low SB, Magnusson I, Thousand RR, Yerneni P, Clark WB. Description and clinical evaluation of a new computerized periodontal probe – the Florida probe. J Clin Periodontol 1988;5:137–44.
    Article Google Scholar
  17. Machtei EE, Norderyd J, Koch G, Dunford R, Grossi S, Genco RJ. The rate of periodontal attachment loss in subjects with established periodontitis. J Periodontol 1993;64:713–8.
    PubMed CAS Google Scholar
  18. Grossi SG, Dunford RG, Ho A, Koch G, Machtei EE, Genco RJ. Sources of error for periodontal probing measurements. J Periodontal Res 1996;31:330–6.
    Article PubMed CAS Google Scholar
  19. Araujo MWB, Hovey K, Benedek J, Grossi SG, Dorn J, Wactawski-Wende J, Genco RJ, Trevisan M. Reproducibility of probing depth measurements using a constant force electronic probe: analysis of inter- and intra-examiner variability. J Periodontol 2003;74:18–22.
    Article Google Scholar
  20. SPSS. SPSS version 11.5 reference guide. Chicago, IL. 2004.
  21. SAS Institute Inc.: SAS/STAT User’s Guide, Version 9. Cary, NC: SAS Institute Inc. 2002.
  22. Jansson LLS, Frithiof L, Theobald H. Relationship between oral health and mortality in cardiovascular diseases. J Clin Periodontol 2001;28:762–8.
    Article PubMed CAS Google Scholar
  23. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA. Periodontal disease and coronary heart disease risk. JAMA 2000;284:1406–10.
    Article PubMed CAS Google Scholar
  24. Hyman JJ, Winn DM, Reid BC. The role of cigarette smoking in the association between periodontal disease and coronary heart disease. J Periodontol 2002;73:988–94.
    Article PubMed Google Scholar
  25. Roeters van Lennep JE, Westeveld HT, Erkelens DW, van Der Wall EE. Risk factors for coronary heart disease: implications of gender. Cardiovasular Res 2002;53(3):538–49.
    Article CAS Google Scholar
  26. Regitz-Zagrosek V, Lehmkuhl E, Weickert MO. Gender differences in the metabolic syndrome and their role for cardiovascular disease. Clin Res Cardiol 2006;95(3):136–47.
    Article PubMed CAS Google Scholar
  27. Andriankaja OM, Dunford R, DeNardin E. The association between metabolic syndrome and periodontal disease. J Dent Res 2006 [abstract 2152].
  28. Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of developing hypertension. JAMA 2003;290:2945–51.
    Article PubMed CAS Google Scholar
  29. Wang TJ, Nam B, Wilson PWF, Wolf PA, Levy D, Polak JF, D’Agostino RB, O’Donnell CJ. Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham heart study. Arterioscler Thromb Vasc Biol 2002;22:1662–7.
    Article PubMed CAS Google Scholar

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Acknowledgments

This project was supported by grants from the National Institute of Health, NIH and the National Institute of Dental and Craniofacial Research, NIDCR: AA 09399 and DE013585: Dr. Maurizio Trevisan; DE12085: Dr. Robert Genco. The authors thank the staff and all participants in this study.

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Authors and Affiliations

  1. Social and Preventive Medicine, SUNY at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA
    Oelisoa Mireille Andriankaja, Joan Dorn, Jacek Dmochowski, Kathy Hovey, Karen L. Falkner & Maurizio Trevisan
  2. School of Dental Medicine, SUNY at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA
    Robert J. Genco

Authors

  1. Oelisoa Mireille Andriankaja
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  2. Robert J. Genco
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  3. Joan Dorn
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  4. Jacek Dmochowski
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  5. Kathy Hovey
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  6. Karen L. Falkner
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  7. Maurizio Trevisan
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Correspondence toOelisoa Mireille Andriankaja.

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Andriankaja, O.M., Genco, R.J., Dorn, J. et al. Periodontal disease and risk of myocardial infarction: the role of gender and smoking.Eur J Epidemiol 22, 699–705 (2007). https://doi.org/10.1007/s10654-007-9166-6

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