BACKGROUND: While growing evidence suggests a link between periodontal disease (PD) and cardiovascular disease (CVD), the independence of this association and the pathway remain unclear. Herein, we tested the hypotheses that: (1) inflammation of the periodontium (PDinflammation ) predicts future CVD independently of disease risk factors shared between CVD and PD, and (2) the mechanism linking the two diseases involves heightened arterial inflammation. METHODS: 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) imaging was performed in 304 individuals (median age 54 years; 42.4% male) largely for cancer screening; individuals without active cancer were included. PDinflammation and arterial inflammation were quantified using validated 18 F-FDG-PET/CT methods. Additionally, we evaluated the relationship between PDinflammation and subsequent major adverse cardiovascular events (MACE) using Cox models and log-rank tests. RESULTS: Thirteen individuals developed MACE during follow-up (median 4.1 years). PDinflammation associated with arterial inflammation, remaining significant after adjusting for PD and CVD risk factors (standardized β [95% CI]: 0.30 [0.20-0.40], P < 0.001). PDinflammation predicted subsequent MACE (standardized HR [95% CI]: 2.25 [1.47 to 3.44], P <0.001, remaining significant in multivariable models), while periodontal bone loss did not. Furthermore, mediation analysis suggested that arterial inflammation accounts for 80% of the relationship between PDinflammation and MACE (standardized log odds ratio [95% CI]: 0.438 [0.019-0.880], P = 0.022). CONCLUSION: PDinflammation is independently associated with MACE via a mechanism that may involve increased arterial inflammation. These findings provide important support for an independent relationship between PDinflammation and CVD.
BACKGROUND: While growing evidence suggests a link between periodontal disease (PD) and cardiovascular disease (CVD), the independence of this association and the pathway remain unclear. Herein, we tested the hypotheses that: (1) inflammation of the periodontium (PDinflammation ) predicts future CVD independently of disease risk factors shared between CVD and PD, and (2) the mechanism linking the two diseases involves heightened arterial inflammation. METHODS: 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) imaging was performed in 304 individuals (median age 54 years; 42.4% male) largely for cancer screening; individuals without active cancer were included. PDinflammation and arterial inflammation were quantified using validated 18 F-FDG-PET/CT methods. Additionally, we evaluated the relationship between PDinflammation and subsequent major adverse cardiovascular events (MACE) using Cox models and log-rank tests. RESULTS: Thirteen individuals developed MACE during follow-up (median 4.1 years). PDinflammation associated with arterial inflammation, remaining significant after adjusting for PD and CVD risk factors (standardized β [95% CI]: 0.30 [0.20-0.40], P < 0.001). PDinflammation predicted subsequent MACE (standardized HR [95% CI]: 2.25 [1.47 to 3.44], P <0.001, remaining significant in multivariable models), while periodontal bone loss did not. Furthermore, mediation analysis suggested that arterial inflammation accounts for 80% of the relationship between PDinflammation and MACE (standardized log odds ratio [95% CI]: 0.438 [0.019-0.880], P = 0.022). CONCLUSION: PDinflammation is independently associated with MACE via a mechanism that may involve increased arterial inflammation. These findings provide important support for an independent relationship between PDinflammation and CVD.
Authors: Matthew J Budoff; Khurram Nasir; Gregory L Kinney; John E Hokanson; R Graham Barr; Robert Steiner; Hrudaya Nath; Carmen Lopez-Garcia; Jennifer Black-Shinn; Richard Casaburi Journal: J Cardiovasc Comput Tomogr Date: 2010-11-22
Authors: Paul Erne; Felix Gutzwiller; Philip Urban; Marco Maggiorini; Pierre-Frédéric Keller; Dragana Radovanovic Journal: Cardiology Date: 2012-04-27 Impact factor: 1.869
Authors: D Ekuni; T Tomofuji; T Sanbe; K Irie; T Azuma; T Maruyama; N Tamaki; J Murakami; S Kokeguchi; T Yamamoto Journal: J Periodontal Res Date: 2009-02-06 Impact factor: 4.419
Authors: Dimitris Papapanagiotou; Elena A Nicu; Sergio Bizzarro; Victor E A Gerdes; Joost C Meijers; Rienk Nieuwland; Ubele van der Velden; Bruno G Loos Journal: Atherosclerosis Date: 2008-05-28 Impact factor: 5.162
Authors: Eugenia Gianos; Elizabeth A Jackson; Astha Tejpal; Karen Aspry; James O'Keefe; Monica Aggarwal; Ankur Jain; Dipti Itchhaporia; Kim Williams; Travis Batts; Kathleen E Allen; Clark Yarber; Robert J Ostfeld; Michael Miller; Koushik Reddy; Andrew M Freeman; Kenneth E Fleisher Journal: Am J Prev Cardiol Date: 2021-04-05
Authors: Rizky A Irwandi; Scott T Chiesa; George Hajishengallis; Venizelos Papayannopoulos; John E Deanfield; Francesco D'Aiuto Journal: Front Immunol Date: 2022-07-07 Impact factor: 8.786