Lee Ya-Ling, Hu Hsiao-Yun, Chou Pesus, Chu Dachen
Department of Dentistry, Taipei City Hospital, Taipei, Taiwan ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan ; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
Clin Interv Aging. 2015 Jan 6;10:175-82. doi: 10.2147/CIA.S67854. eCollection 2015.
To investigate the association between periodontal disease (PD) and acute myocardial infarction (AMI), and evaluate the effect of dental prophylaxis on the incidence rate (IR) of AMI.
The Longitudinal Health Insurance Database 2000 from the National Health Insurance program was used to identify 511,630 patients with PD and 208,713 without PD during 2000-2010. Subjects with PD were grouped according to treatment (dental prophylaxis, intensive treatment, and PD without treatment). The IRs of AMI during the 10-year follow-up period were compared among groups. Cox regression analysis adjusted for age, sex, socioeconomic status, residential urbanicity, and comorbidities was used to evaluate the effect of PD treatment on the incidence of AMI.
The IR of AMI among subjects without PD was 0.19%/year. Among those with PD, the IR of AMI was lowest in the dental prophylaxis group (0.11%/year), followed by the intensive treatment (0.28%/year) and PD without treatment (0.31%/year; P<0.001) groups. Cox regression showed that the hazard ratio (HR) for AMI was significantly lower in the dental prophylaxis group (HR =0.90, 95% confidence interval =0.86-0.95) and higher in the intensive treatment (HR =1.09, 95% confidence interval =1.03-1.15) and PD without treatment (HR =1.23, 95% confidence interval =1.13-1.35) groups than in subjects without PD.
PD is associated with a higher risk of AMI, which can be reduced by dental prophylaxis to maintain periodontal health.
研究牙周病（PD）与急性心肌梗死（AMI）之间的关联，并评估牙周预防对AMI发病率（IR）的影响。
使用来自国民健康保险计划的2000年纵向健康保险数据库，确定2000年至2010年期间511,630例患有PD的患者和208,713例未患有PD的患者。患有PD的受试者根据治疗情况（牙周预防、强化治疗和未治疗的PD）进行分组。比较各组在10年随访期内AMI的发病率。采用Cox回归分析，对年龄、性别、社会经济地位、居住城市性和合并症进行校正，以评估PD治疗对AMI发病率的影响。
未患有PD的受试者中AMI的发病率为0.19%/年。在患有PD的受试者中，牙周预防组AMI的发病率最低（0.11%/年），其次是强化治疗组（0.28%/年）和未治疗的PD组（0.31%/年；P<0.001）。Cox回归显示，牙周预防组AMI的风险比（HR）显著较低（HR =0.90，95%置信区间 =0.86 - 0.95），强化治疗组（HR =1.09，95%置信区间 =1.03 - 1.15）和未治疗的PD组（HR =1.23，95%置信区间 =1.13 - 1.35）的HR高于未患有PD的受试者。
PD与较高的AMI风险相关，通过牙周预防维持牙周健康可降低该风险。
