Resumen de Periodontal Status Affects C-Reactive Protein and Lipids in Patients With Stable Heart Disease From a Tertiary Care Cardiovascular Clinic
Background: There are scarce data on the impact of the periodontal condition in the control of biomarkers in patients with cardiovascular disease (CVD). The aim of this study is to assess whether periodontal inflammation and tissue breakdown are associated with C-reactive protein (CRP) and lipids in patients with stable heart disease.
Methods: This cross-sectional study included 93 patients with stable coronary artery disease (57 males; mean age: 63.5 ± 9.8 years) who were in outpatient care for at least 6 months. After applying a structured questionnaire, periodontal examinations were performed by two calibrated periodontists in six sites per tooth at all teeth. Blood samples were collected from patients on the day of periodontal examination to determine levels of CRP, lipids, and glycated hemoglobin. Multiple linear regression models were fitted to evaluate the association among different periodontal and blood parameters controlling for sex, body mass index, glycated hemoglobin, use of oral hypoglycemic drugs, and smoking.
Results: Overall, the sample presented high levels of periodontal inflammation and tissue breakdown. Unadjusted mean concentrations of triglycerides (TGs), very-low-density lipoprotein cholesterol, and glucose were significantly higher in individuals with severe periodontitis. When multiple linear regression models were applied, number of teeth with clinical attachment loss =6 mm and presence of severe periodontitis were significantly associated with higher CRP concentrations. Bleeding on probing was significantly associated with TGs, total cholesterol, and non-high-density lipoprotein cholesterol.
Conclusion: In this sample of patients with stable CVD, current periodontal inflammation and tissue breakdown are associated with cardiovascular inflammatory markers, such as CRP and lipid profile.
A variety of preventive strategies for cardiovascular disease (CVD) has been supported in the literature, mainly including lifestyle modification (exercise, weight control, sodium reduction, smoking cessation) and medication.1,2 These strategies are mostly involved in the control of risk markers of CVD, including C-reactive protein (CRP), triglycerides (TGs), cholesterol, blood pressure, and glucose. In this regard, statins are among the most important drugs that aim to reduce the risk for major cardiovascular events by means of cholesterol control.3 There is a substantial body of evidence, mainly from observational and case-control studies, associating periodontal disease to CVD.4-9 The evidence includes higher odds of cardiovascular events in periodontitis patients;4,7 elevation of blood risk markers of CVD, such as CRP, in otherwise healthy patients with periodontitis; and reduction of such markers after periodontal therapy.10,11 It is noteworthy that most of these data was obtained in individuals in good general health without CVD, and little evidence exists regarding the role of periodontal disease in recurrence of CVD.12,13 The control of CVD risk markers is affected by several factors, including cigarette smoking, hypertension, sex, obesity, and age.14 To the best of the authors� knowledge, there is no study evaluating the association between periodontal condition and blood risk markers in patients with stable CVD from Latin America. This information would be of great importance to CVD patients and caregivers, with the aim of improving prevention of future cardiovascular events.
The purpose of the present study is to assess the association among periodontal status, CRP, and lipids in patients with stable heart disease from a tertiary care cardiovascular clinic. The hypothesis is that higher periodontal inflammation and tissue breakdown may be associated with elevated levels of CRP and lipids in patients with stable CVD.
