Association between periodontal disease and acute myocardial infarction

Coronary heart disease is the leading cause of morbidity and mortality throughout the world. Well-known risk factors independently or combined participate in both myocardial infarction and atherosclerosis. Recent data have shown that viral and bacterial infections may also contribute to the acute thromboembolic events. The aim of the present study was to investigate the possible association between periodontal health and coronary heart disease in patients with acute myocardial infarction and chronic coronary heart disease.

A total of 120 patients, 60 with acute myocardial infarction (AMI) and 60 with chronic coronary heart disease (CCHD) were included in this study. The patients in the AMI group (50 men and 10 women; mean age 53.8 +/- 9.5 years) were admitted to the Department of Cardiology, University Hospital of Ege because of AMI. The CCHD patients group (42 men and 18 women; mean age 58.5 +/- 11.6 years) had no documented history of recent acute coronary events. All patients were clinically examined and completed a medical questionnaire. Missing teeth, restorations, probing depth (PD) and bleeding on probing (BOP) were recorded. Blood samples were taken on admission for measurements of serum total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol), and fasting blood glucose level. Sample proportions were compared by chi square test, quantitative variables with Student t test. The relation of clinical parameters and conventional risk factors to AMI was assessed with logistic regression analysis.

The number of sites with PD > or = 4 mm, the percentage of sites exhibiting BOP, smoking status, total cholesterol, LDL-cholesterol, and triglycerides were statistically different between AMI and CCHD groups (P <0.05). Logistic regression analysis showed that the percentage of sites exhibiting BOP, the number of sites with PD > or = 4, the number of restorations, smoking status, and triglycerides levels were significantly associated with AMI (P <0.05).

The results of this study indicate that periodontal disease may be associated with acute myocardial infarction. To our knowledge, this is the first study that reports the importance of periodontal health in the occurrence of acute myocardial infarction in a Turkish population. We propose that prospective randomized studies are needed to determine whether periodontal disease is a risk factor in the occurrence of acute myocardial infarction.