Bazile Anca, Bissada Nabil F, Nair Ravi, Siegel Burton P
Department of Periodontics, Case Western Reserve University, Cleveland, OH 44106-4905, USA.
J Periodontol. 2002 Jun;73(6):631-6. doi: 10.1902/jop.2002.73.6.631.
The purpose of this cross-sectional study was to assess the periodontal condition of patients with coronary artery disease (CAD) in order to verify the association between CAD and certain periodontal parameters.
Eighty patients (48 males and 32 females) were recruited from the Cleveland University Hospitals, Division of Cardiology (aged 23 to 83, median age 54 years). Upon cardiac catheterization, 50 were diagnosed with severe CAD (experimental group) and 30 with no angiographic evidence of CAD (control group). Patients with CAD were divided into 3 subgroups according to the clinical diagnosis of acute infarction (Al) (n = 20), stable angina (SA) (n = 20), and unstable angina (UA) (n = 10). The following dental, medical, and social histories were recorded: number of dental visits/year, frequency of brushing/day and flossing/week, tobacco use, presence/absence of hypertension, diabetes, total cholesterol level, and the highest level of education completed. The following periodontal parameters were also assessed for each subject: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of missing teeth. Logistic regression analysis was used to determine whether there was a significant correlation between these periodontal parameters and CAD.
The significant confounding factors for the present study were found to be age and gender. The periodontal condition of the 80 subjects was clinically diagnosed as gingivitis and/or mild periodontitis. Analysis of the data after adjusting for age and gender demonstrated a statistically significant association between BOP and GI and CAD in patients with Al; and facial/lingual CAL in patients with UA. No significant associations were found between PD, interproximal CAL, number of missing teeth, or dental/medical histories and CAD.
Based on the results of this study, gingival inflammation may be considered a more significant risk factor for CAD than previously reported.
本横断面研究的目的是评估冠状动脉疾病（CAD）患者的牙周状况，以验证CAD与某些牙周参数之间的关联。
从克利夫兰大学医院心脏病学部招募了80名患者（48名男性和32名女性）（年龄23至83岁，中位年龄54岁）。在进行心脏导管插入术时，50名被诊断为重度CAD（实验组），30名无CAD血管造影证据（对照组）。CAD患者根据急性梗死（AI）（n = 20）、稳定型心绞痛（SA）（n = 20）和不稳定型心绞痛（UA）（n = 10）的临床诊断分为3个亚组。记录了以下牙科、医学和社会病史：每年看牙次数、每天刷牙频率和每周使用牙线频率、吸烟情况、是否患有高血压、糖尿病、总胆固醇水平以及完成的最高教育水平。还对每个受试者评估了以下牙周参数：菌斑指数（PI）、牙龈指数（GI）、探诊出血（BOP）、探诊深度（PD）、临床附着水平（CAL）和缺失牙数量。使用逻辑回归分析来确定这些牙周参数与CAD之间是否存在显著相关性。
本研究的显著混杂因素为年龄和性别。80名受试者的牙周状况临床诊断为牙龈炎和/或轻度牙周炎。在调整年龄和性别后对数据进行分析，结果显示AI患者中BOP和GI与CAD之间存在统计学显著关联；UA患者中面部/舌侧CAL与CAD之间存在统计学显著关联。未发现PD、邻面CAL、缺失牙数量或牙科/医学病史与CAD之间存在显著关联。
基于本研究结果，牙龈炎症可能被认为是CAD比先前报道更为重要的危险因素。
