Periodontitis as risk factor for acute
myocardial infarction
Journal of Periodontal Research Volume 40 Issue 1 Page
36 -
February 2005
Periodontitis as risk factor for acute myocardial infarction.
A case
control study of Spanish adults
A. Cueto, F. Mesa, M. Bravo, R. Ocaña-Riola
Objective: The present study was designed to determine, in a case-
control study of a Spanish population, whether periodontitis is
a risk factor for acute myocardial infarction.
Background: Although part of cardiovascular risk could be explained
by periodontal disease, available meta-analyses find significant
heterogeneity and recommend the need for further observational
and intervention studies.
Methods: A case-control study was conducted of 149 Spanish patients
aged between 40 and 75 years, with 72 cases (acute myocardial
infarction) and 77 controls (trauma patients). Periodontitis was
measured as the percentage of sites with clinical attachment loss
greater than 3 mm. A multivariate logistic regression model was
constructed to estimate the adjusted effect of periodontitis on
acute myocardial infarction, after considering the potential confounding
effect of a large pool of risk factors.
Results: In a bivariate analysis, males, older patients, smokers,
and those with hypertension, diabetes or hypercholesterolemia,
showed an increased risk of acute myocardial infarction. The cases,
compared to controls, showed worse results for all periodontal
variables studied: gingival retraction, pocket depth, and periodontitis.
The final multiple logistic model included sex, age, tobacco habit,
hypertension, diabetes, hypercholesterolemia, regular exercise,
and periodontitis. The association between periodontitis (dichotomized)
and acute myocardial infarction was high and significant in both
the unadjusted (odds ratio = 4.42, p < 0.001) and adjusted
analyses (odds ratio = 3.31, p = 0.005).
Conclusion: There is evidence of an association between periodontitis
and acute myocardial infarction after adjusting for well-known
risk factors for acute myocardial infarction.
