Periodontal disease classifications and incident coronary heart disease in the Atherosclerosis Risk in Communities study

作者：James D. Beck, Kamaira Philips, Kevin Moss, Souvik Sen, Thiago Morelli, John S. Preisser, James S. Pankow · 发表于：Journal of Periodontology · 年份：2020 · DOI：10.1002/jper.19-0723 · 被引用次数：34 · 研究领域：Oral microbiology and periodontitis research、Dental Radiography and Imaging、Dental Health and Care Utilization

BACKGROUND: Periodontal disease has been linked to coronary heart disease (CHD), but studies have been inconclusive. This study investigates the link between periodontal disease and incident CHD. METHODS: Baseline periodontal data from a full-mouth periodontal exam (N = 6,300) and CHD outcomes through 2017 were obtained from the Atherosclerosis Risk in Communities Study. Periodontitis was defined by the Periodontal Profile Class System adapted to Stages (PPC stages) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) index. Competing risk models were used to determine hazard ratios (HR) for incident CHD, congestive heart failure (CHF), and other causes of death. Secondary analysis included myocardial infarction (MI) and fatal CHD. RESULTS: Females comprised 56% of participants and males 44% with a combined mean age of 62.3 years (range: 52 to 74). Participants were followed for an average of 16.7 (SD: 5.5) years. In a fully adjusted model, PPC stage VII (Severe Tooth Loss) was moderately significantly related to incident CHD, (HR 1.51 [1.11 to 2.09]). PPC stage V (Mild Tooth Loss/High Gingival Inflammation) was significant for fatal CHD (HR, 5.27 [1.80 to 15.4]) and PPC stage VII was significant for incident MI (HR, 1.59 [1.13 to 2.23]). The CDC/AAP definition was not significantly associated with incident CHD. CONCLUSIONS: Incident CHD was moderately significantly associated with a specific stage of periodontal disease characterized by severe too...