Department of Cardiology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa City, Chiba Prefecture, Japan.
Am Heart J. 2012 Feb;163(2):164-7. doi: 10.1016/j.ahj.2011.10.012.
Numerous reports have demonstrated that periodontal bacteria are present in plaques from atherosclerotic arteries. Although periodontitis has recently been recognized as a risk factor for coronary artery disease, the direct relationship between periodontal bacteria and coronary artery disease has not yet been clarified. It has been suggested that these bacteria might contribute to inflammation and plaque instability. We assumed that if periodontal bacteria induce inflammation of plaque, the bacteria would be released into the bloodstream when vulnerable plaque ruptures. To determine whether periodontal bacteria are present in thrombi at the site of acute myocardial infarction, we tried to detect periodontal bacteria in thrombi of patients with acute myocardial infarction by polymerase chain reaction (PCR).
We studied 81 consecutive adults with ST-segment elevation acute myocardial infarction who underwent primary percutaneous coronary intervention (PCI). All patients underwent removal of thrombus with aspiration catheters at the beginning of percutaneous coronary intervention, and a small sample of thrombus was obtained for PCR.
The detection rates of periodontal bacteria by PCR were 19.7% for Aggregatibacter actinomycetemcomitans, 3.4% for Porphyromonas gingivalis, and 2.3% for Treponema denticola.
Three species of periodontal bacteria were detected in the thrombi of patients with acute myocardial infarction. This raises the possibility that such bacteria are latently present in plaque and also suggests that these bacteria might have a role in plaque inflammation and instability.
许多报告表明,牙周细菌存在于动脉粥样硬化动脉的斑块中。虽然牙周炎最近被认为是冠心病的一个危险因素,但牙周细菌与冠心病之间的直接关系尚未阐明。有人认为,这些细菌可能导致炎症和斑块不稳定。我们假设,如果牙周细菌引起斑块炎症,当易损斑块破裂时,这些细菌就会释放到血液中。为了确定牙周细菌是否存在于急性心肌梗死部位的血栓中,我们尝试通过聚合酶链反应(PCR)检测急性心肌梗死患者血栓中的牙周细菌。
我们研究了 81 例连续的 ST 段抬高急性心肌梗死患者,他们接受了直接经皮冠状动脉介入治疗(PCI)。所有患者在经皮冠状动脉介入治疗开始时均采用抽吸导管清除血栓,并从血栓中取出一小部分样本进行 PCR。
PCR 检测到牙周细菌的检出率分别为伴放线放线杆菌 19.7%、牙龈卟啉单胞菌 3.4%和牙髓密螺旋体 2.3%。
在急性心肌梗死患者的血栓中检测到三种牙周细菌。这提示这些细菌可能潜伏在斑块中,也提示这些细菌可能在斑块炎症和不稳定中起作用。