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Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A

Steven Bell1, Joel T Gibson1, Eric L Harshfield1

  • 1Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Atherosclerosis
|October 10, 2020
PubMed

Insights

This study used Mendelian randomization to investigate if periodontitis causes stroke or coronary artery disease. Findings show no causal link, suggesting observational associations may be due to confounding factors.

Area of Science:

  • Cardiovascular Epidemiology
  • Periodontal Disease Research
  • Genetic Epidemiology

Background:

  • Observational studies suggest a link between periodontitis and cardiovascular disease (CVD).
  • The causal nature of this association remains uncertain.
  • Mendelian randomization is employed to investigate causality.

Purpose of the Study:

  • To determine if periodontitis causally influences the risk of stroke.
  • To assess if periodontitis causally influences the risk of coronary artery disease (CAD).
  • To investigate the causal relationship between periodontitis and subclinical atherosclerosis.

Main Methods:

  • A two-sample Mendelian randomization analysis was conducted.
  • Utilized genome-wide association study data for periodontitis, stroke (MEGASTROKE, UK Biobank), and coronary artery disease (CARDIoGRAMplusC4D, UK Biobank).
  • Carotid intima-media thickness from UK Biobank served as a marker for subclinical atherosclerosis.

Main Results:

  • No statistically significant association was found between periodontitis and stroke (OR 0.99, 95% CI 0.97–1.02).
  • No significant association was observed for periodontitis and coronary artery disease (OR 1.01, 95% CI 0.99–1.03).
  • Periodontitis showed no association with subclinical atherosclerosis (β -0.002, 95% CI -0.004–0.001).

Conclusions:

  • The study provides no robust evidence for a causal relationship between periodontitis and stroke or coronary artery disease.
  • Findings suggest that previously reported associations in observational studies may be attributed to confounding.
  • Further research may be needed to fully elucidate the complex relationship between oral health and cardiovascular outcomes.
Abstract

Keywords:
Carotid intima-media thicknessCoronary artery diseaseInflammationMendelian randomizationPeriodontitisRisk factorStroke

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