Periodontitis and Acute Myocardial Infarction Among Patients Visiting a Tertiary Care Center in Koshi Province of...

Acute myocardial infarction (AMI) is the leading cardiovascular cause of morbidity and mortality worldwide. Atherosclerosis and acute thromboembolic events have been found to be related to chronic dental infections. But the evidence of the causal association of periodontitis and AMI is conflicting. This study was conducted to assess the association between chronic periodontitis and AMI among patients visiting a tertiary care center in Koshi Province of Nepal.

A case-control study was conducted among 37 cases of AMI admitted to cardiology ward of B.P. Koirala Institute of Health Sciences (BPKIHS) and 37 controls from the relatives of the patients with no history of myocardial infarction. Data on sociodemographic characteristics, personal habits, and medical history was collected using a structured questionnaire. Blood pressure and BMI of each participant were measured. Medical data of patients were extracted from the patient files, and for controls, blood tests were done to determine random blood glucose and cholesterol levels. Oral examination was done to assess oral hygiene status, number of teeth present, and periodontal status. Multivariate logistic regression analysis used two models to adjust for the confounding variables. The level of significance was set at p  < 0.05.

Lower number of teeth and periodontitis were associated with an increased risk of having AMI with an odds ratio (OR) of 0.89; 95% CI: 0.82-0.97; p = 0.006 and OR = 2.85; 95% CI: 1.08-7.52; p = 0.034, respectively. A significant association was found between AMI and the presence of a lower number of teeth in the confounding factors-adjusted model. The significant association between periodontitis and myocardial infarction was lost in both Models I and II after adjusting for other risk factors (adjusted OR = 1.49; 95% CI: 0.45-4.96; p = 0.515 and OR = 1.39; 95% CI: 0.37-5.29; p = 0.63, respectively).

This study did not find significant association between periodontitis and AMI on adjusting for other risk factors. However, the crude marker of periodontitis, lower number of teeth present, was associated with the higher risk of AMI. Further studies are required to fully understand the nature of association of periodontitis and AMI.