Periodontitis in Patients Undergoing Coronary Angiography: A Cross-Sectional Study

Background Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, with coronary artery disease (CAD) being the primary contributor. Periodontitis, a common non-communicable disease, has been associated with an increased risk of CVD. Previous studies have suggested a link between the severity of periodontitis and the degree of coronary artery obstruction. Objective This study aims to investigate the correlation between the severity of periodontitis and coronary artery stenosis, as measured by the SYNTAX score I (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery), and to examine the association between severe periodontitis and other coronary pathologies, such as diffuse coronary disease and coronary thrombosis. Materials and methods An observational cross-sectional study was conducted at the Second Cardiology Clinic, University Multiprofile Hospital for Active Treatment "St. Marina", Varna, Bulgaria, from December 2021 to January 2024. A total of 199 patients aged 45-64 years, indicated for coronary angiography, were included. Periodontal assessment included measuring probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BoP), and plaque index (PI). Subgingival plaque samples were analyzed for periodontal pathogens. Coronary angiography was performed, and the SYNTAX score I was calculated to assess the severity of coronary artery stenosis. Statistical analyses, including chi-square tests and Spearman's correlation, were conducted to evaluate the associations. Results Among the 199 participants, 74.9% had severe periodontitis (stage III and IV). A weak but statistically significant correlation was found between mean CAL, periodontitis stage, and the SYNTAX score I (p < 0.01 and p < 0.05, respectively), indicating that more severe forms of periodontitis were associated with greater coronary artery stenosis. No correlation was observed between the presence of periodontal pathogens or the total microbial count and the SYNTAX score I. Additionally, no association was found between severe periodontitis and other coronary conditions, such as diffuse coronary disease and thrombosis. Conclusion This study provides new insights into the relationship between periodontal infection and coronary artery disease. Our findings suggest that severe periodontitis is significantly associated with a higher frequency and more complex coronary lesions, as indicated by the SYNTAX score I. However, no link was observed between specific periodontal pathogens and coronary stenosis. These results underscore the importance of early diagnosis and management of periodontal infections in patients with CAD, highlighting the potential benefits of an integrated approach to managing cardiovascular and periodontal health. Further studies are needed to explore these associations in more depth.