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Published on: December 11, 2016
Acute myocardial infarct size is related to periodontitis extent and severity
R Marfil-Álvarez1, F Mesa2, A Arrebola-Moreno3
1Department of Periodontics, School of Dentistry, University of Granada, Spain.
Insights
The extent and severity of chronic periodontitis are linked to larger acute myocardial infarct size. This suggests gum disease may worsen heart attack outcomes, impacting cardiac troponin I and myoglobin levels.
Area of Science:
- Periodontology
- Cardiology
- Biomarkers
Background:
- Cardiovascular diseases are leading causes of death globally.
- The link between periodontitis and acute myocardial infarction is known, but infarct size impact is unclear.
Purpose of the Study:
- To investigate the association between chronic periodontitis extent/severity and acute myocardial infarct size.
- To assess cardiac troponin I and myoglobin levels as indicators of infarct size in relation to periodontitis.
Main Methods:
- Cross-sectional analytic study of 112 myocardial infarction patients.
- Collected sociodemographic, periodontal (Arbes Index, Periodontal Inflammatory Severity Index), cardiologic, and hematologic data.
- Used regression analysis to determine associations and mediated effects.
Main Results:
- Periodontitis extent and severity correlated significantly with troponin I levels.
- Periodontitis extent was associated with myoglobin, total leukocytes, and neutrophil levels.
- Leukocytes and neutrophils may mediate the relationship between periodontitis and infarct size biomarkers.
Conclusions:
- Chronic periodontitis extent and severity are positively associated with acute myocardial infarct size.
- This research provides initial evidence linking gum disease severity to heart attack damage.
- Further research into the role of inflammatory markers is warranted.
Abstract:
Cardiovascular disease has been associated with 40% of deaths in high-income countries and 28% in lower-income countries. The relationship between periodontitis and acute myocardial infarction is well documented, but it has not been established whether the extent and severity of periodontitis influence the infarct size. This cross-sectional and analytic study was designed to investigate the association of chronic periodontitis extent and severity with acute myocardial infarct size as indicated by serum cardiac troponin I and myoglobin levels. Sociodemographic, periodontal, cardiologic, and hematologic variables were gathered in 112 consecutive patients with myocardial infarction. The extent (Arbes Index) and severity (Periodontal Inflammatory Severity Index) of the chronic periodontitis were significantly associated with troponin I levels after controlling for sociodemographic and clinical confounders (change in R (2) = .041, p < .02, and R (2) = .031, p = .04). However, only the extent index accounted for levels of myoglobin (change in R (2) = .030, p < .05), total leukocytes (change in R (2) = .041 p < .02), and neutrophils (change in R (2) = .059, p < .01). Mediated regression analysis showed that leukocytes and neutrophils may underlie these observed relationships of chronic periodontitis with troponin I and myoglobin. To our knowledge, this study contributes the first research data demonstrating that the extent and severity of periodontitis is positively associated with acute myocardial infarct size as measured by serum troponin I and myoglobin levels.
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