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Periodontitis Increases the Risk of a First Myocardial Infarction A Report From the PAROKRANK Study

Ryden, Lars (author)
Karolinska Institutet
Buhlin, Kare (author)
Karolinska Institutet
Ekstrand, Eva (author)
Karolinska Institutet
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de Faire, Ulf (author)
Karolinska Institutet
Gustafsson, Anders (author)
Karolinska Institutet
Holmer, Jacob (author)
Karolinska Institutet
Kjellstrom, Barbro (author)
Karolinska Institutet
Lindahl, Bertil (author)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
Norhammar, Anna (author)
Karolinska Institutet
Nygren, Ake (author)
Karolinska Institutet
Näsman, Per (author)
KTH,Transportplanering, ekonomi och teknik,KTH Royal Inst Technol, Ctr Safety Res, Stockholm, Sweden.
Rathnayake, Nilminie (author)
Karolinska Inst, Dept Dent Med, Stockholm, Sweden.
Svenungsson, Elisabet (author)
Karolinska Inst, Dept Med K2, Stockholm, Sweden.
Klinge, Björn (author)
Karolinska Institutet,Malmö högskola,Odontologiska fakulteten (OD),Karolinska Inst, Dept Dent Med, Stockholm, Sweden.
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 (creator_code:org_t)
Lippincott Williams & Wilkins, 2016
2016
English.
In: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 133:6, s. 576-583
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. Methods and Results Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 628), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (approximate to 100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2x2 contingency tables. Contingency tables exceeding 2x2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). Conclusions In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

case-control study
causality
myocardial infarction
periodontitis
radiography
panoramic
risk factors

Publication and Content Type

ref (subject category)
art (subject category)

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