Periodontitis Progression During Cardiac Rehabilitation After Acute Coronary Syndrome: Cohort Study

To assess changes in periodontal status and factors related to periodontitis progression in acute coronary syndrome patients who undergo a cardiovascular rehabilitation program following an acute coronary incident.

Fifty-two acute coronary syndrome patients with periodontitis were evaluated during a six-month follow-up period. Periodontal indices were taken at baseline and at 3 and 6 months. Progression of periodontitis was established as clinical attachment loss > 3 mm in two or more teeth at nonadjacent sites. Baseline clinical conditions, microbiological concentration of subgingival biofilm, and risk factors for cardiovascular disease were associated with the incidence of periodontitis progression by a linear mixed-effects model.

57.69% of the patients had severe periodontitis upon admission, and 64.58% presented a progression of periodontitis during the follow-up periods. Hypertension, low HDL, and high levels of T. forsythia in patients with elevated total cholesterol were the best predictors of clinical attachment loss, with a predictability of 99%. At 6 months, 35.41% of patients' high-sensitivity C-reactive protein (hs-CRP) levels remained over the cardiovascular risk range.

Periodontal condition deterioration was observed. Hypertension and poor metabolic control were associated with the progression of periodontitis. T. forsythia was the most critical local factor in periodontitis progression.