Periodontal Health of AMI Patients. Cross-sectional Observations and 10-Year Mortality

Objectives: To investigate the periodontal health condition in patients who had recently suffered acute myocardial infarction (AMI). Methods: A case-control approach was used to compare 98 AMI cases with 77 healthy controls accounting for age, gender and smoking. The definition of AMI was based on ECG-changes and increased levels of myocardial markers. Radiographic bone height assessed from a full set of intra-oral radiographs, mean pocket depth (PD), proportion of sites with gingival bleeding (GB), and proportion of surfaces exhibiting dental plaque (PL) were the main periodontal variables studied. Additionally, the occurrence of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) was tested with standard culturing methods. Baseline data were collected in 1996-97. The mortality of AMI cases was evaluated in 2007 after 8-12 years (mean 10.5 years) following inclusion. Data were statistically treated with multifactorial ANOVA. The null-hypothesis was rejected at p<0.05. Results: The level of periodontal bone height was significantly decreased in AMI cases compared to controls (73.2% vs 80.3%, p<0.05). Mean PD (2.35mm vs 2.28mm), mean GB (25.8% vs 23.9%), and mean PL (68.2% vs 65.8%) were not significantly different in AMI cases and controls (p>0.05). The occurrence of Aa, Pg, or Pi did not differ between groups (p>0.05). There were no differences regarding all periodontal baseline data between AMI cases who did (n=85) and did not (n=13) survive the 10-year follow-up survey. Conclusion: The observations suggest an association between severe ischemic heart disease and periodontal bone loss. No associations were observed either with typical periodontal inflammatory signs such as pocket depth and gingival bleeding or with markers of infection such as dental plaque and some alleged periodontal pathogens. The periodontal condition did not influence the 10-year cardiovascular mortality.