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洗牙与心房颤动:一项全国性队列研究。

Dental scaling and atrial fibrillation: a nationwide cohort study.

作者信息

Chen Su-Jung, Liu Chia-Jen, Chao Tze-Fan, Wang Kang-Ling, Chen Tzeng-Ji, Chou Pesus, Wang Fu-Der, Lin Shing-Jong, Chiang Chern-En

机构信息

Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital Su-Ao and Yuanshan branch, I-Lan, Taiwan; Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Int J Cardiol. 2013 Oct 3;168(3):2300-3. doi: 10.1016/j.ijcard.2013.01.192. Epub 2013 Feb 28.

Abstract

BACKGROUND

Improvement of oral hygiene through dental scaling was associated with a decreased risk of cardiovascular events. The goal of the present study was to investigate whether dental scaling can reduce the risk of atrial fibrillation (AF).

METHODS

In year 2000, a total of 28,909 subjects who were age 60 or more without past history of cardiac arrhythmias were identified from the "National Health Insurance Research Database" in Taiwan. Among these subjects, those who have received dental scaling at least 1 time/year for 3 consecutive years (1998-2000) were selected to be the exposed group (n=3391). A total of 13,564 age, sex and underlying disease-matched subjects without receiving dental scaling were identified to be the non-exposed group. The study endpoint was the occurrence of new-onset AF.

RESULTS

During a follow-up of 4.6 ± 1.1 years, 478 participants (2.8%) developed AF. The exposed group had a lower AF occurrence rate than non-exposed group (2.2% versus 3.0%; p value=0.017). After an adjustment with age, gender, and comorbidities in the multivariate analysis, dental scaling was associated with a reduced risk of AF (hazard ratio=0.671, 95% CI=0.524-0.859; p value=0.002). Among the exposed group, the hazard ratio in developing AF was 0.340 (95% CI=0.247-0.489; p value <0.001) when subjects received 1 more dental scaling per year.

CONCLUSIONS

The risk of AF was lower in subjects receiving dental scaling. Improvement of oral hygiene by dental scaling may be a simple and useful way to prevent AF.

摘要

背景

通过洗牙改善口腔卫生与心血管事件风险降低相关。本研究的目的是调查洗牙是否能降低心房颤动(AF)的风险。

方法

2000年,从台湾“国民健康保险研究数据库”中识别出28909名60岁及以上且无心律失常病史的受试者。在这些受试者中,选择那些在1998 - 2000年连续3年每年至少接受1次洗牙的受试者作为暴露组(n = 3391)。总共13564名年龄、性别和基础疾病匹配且未接受洗牙的受试者被确定为非暴露组。研究终点是新发房颤的发生。

结果

在4.6±1.1年的随访期间,478名参与者(2.8%)发生了房颤。暴露组的房颤发生率低于非暴露组(2.2%对3.0%;p值 = 0.017)。在多变量分析中对年龄、性别和合并症进行调整后,洗牙与房颤风险降低相关(风险比 = 0.671,95%置信区间 = 0.524 - 0.859;p值 = 0.002)。在暴露组中,每年多接受1次洗牙的受试者发生房颤的风险比为0.340(95%置信区间 = 0.247 - 0.489;p值<0.001)。

结论

接受洗牙的受试者房颤风险较低。通过洗牙改善口腔卫生可能是预防房颤的一种简单而有效的方法。

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