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Links: antibodies to periodontal pathogens and stroke risk.
Pussinen PJ, Alfthan G, Rissanen H, Reunanen A, Asikainen S, Knekt P.
Institute of Dentistry, University of Helsinki, P.O. Box 63 (Haartmaninkatu
8), FIN-00014 Helsinki, Finland. pirkko.pussinen@helsinki.fi
BACKGROUND AND PURPOSE: The association between cerebrovascular events and
periodontitis has been found in few studies based on clinical periodontal
examinations. However, evidence on the association between periodontal
pathogens and stroke is lacking. Therefore, the aim of the study was to
investigate whether elevated levels of serum antibodies to major periodontal
pathogens predict stroke in a case-control study.
METHODS: The study population comprised 6950 subjects (aged 45 to 64 years) who participated in
the Mobile Clinic Health Survey in 1973 to 1976 in Finland. During a
follow-up of 13 years, a total of 173 subjects had a stroke. From these, 64
subjects had already experienced a stroke or had signs of coronary heart
disease (CHD) at baseline, whereas 109 subjects were apparently healthy. Two
controls per case were matched for age, gender, municipality, and disease
status. Serum IgG and IgA class antibody levels to the periodontal
pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas
gingivalis, were determined by multiserotype enzyme-linked immunosorbent
assay.
RESULTS: The cases identified during the follow-up that were free of
stroke or CHD at baseline were more often IgA-seropositive for A.
actinomycetemcomitans than were their controls, 41.3% versus 29.3%. Compared
with the seronegative, the seropositive subjects had a multivariate odds
ratio of 1.6 (95% CI, 1.0 to 2.6) for stroke. The patients with a history of
stroke or CHD at baseline were more often IgA-seropositive for P. gingivalis
than were their controls, 79.7% versus 70.2%. When compared with the
seronegative, the seropositive subjects had an odds ratio of 2.6 (1.0 to
7.0) for secondary stroke.
CONCLUSIONS: The present prospective study
provides serological evidence that an infection caused by major periodontal
pathogens is associated with future stroke.
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