Sen Souvik, Chung Matthew, Duda Viktoriya, Giamberardino Lauren, Hinderliter Alan, Offenbacher Steven
University of South Carolina, Columbia, South Carolina.
University of South Carolina, Columbia, South Carolina.
J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2137-2144. doi: 10.1016/j.jstrokecerebrovasdis.2017.04.035. Epub 2017 May 24.
Periodontal disease (PD) is associated with recurrent vascular event in stroke or transient ischemic attack (TIA). In this study, we investigated whether PD is independently associated with aortic arch atheroma (AA). We also explored the relationship PD has with AA plaque thickness and other characteristics associated with atheroembolic risk among patients with stroke or TIA. Finally, we confirmed the association between AA and recurrent vascular event in patients with stroke or TIA.
In this prospective longitudinal hospital-based cohort study, PD was assessed in patients with stroke and TIA. Patients with confirmed stroke and TIA (n = 106) were assessed by calibrated dental examiners to determine periodontal status and were followed over a median of 24 months for recurrent vascular events (stroke, myocardial infarction, and death). The extent of AA and other plaque characteristics was assessed by transesophageal echocardiography.
Within our patient cohort, 27 of the 106 participants had recurrent vascular events (including 16 with stroke or TIA) over the median of 24-month follow-up. Severe PD was associated with increased AA plaque thickness and calcification. The results suggest that PD may be a risk factor for AA. In this cohort, we confirm the association of severe AA with recurrent vascular events.
In patients with stroke or TIA, severe PD is associated with increased AA plaque thickness, a risk factor for recurrent events. Further studies are needed to confirm this finding and to determine whether treatment of PD can reduce the rate of AA plaque progression and recurrent vascular events.
牙周疾病（PD）与中风或短暂性脑缺血发作（TIA）后的复发性血管事件相关。在本研究中，我们调查了PD是否与主动脉弓粥样硬化（AA）独立相关。我们还探讨了PD与中风或TIA患者的AA斑块厚度以及其他与动脉粥样硬化栓塞风险相关特征之间的关系。最后，我们证实了AA与中风或TIA患者复发性血管事件之间的关联。
在这项基于医院的前瞻性纵向队列研究中，对中风和TIA患者进行了PD评估。由经过校准的牙科检查人员对确诊为中风和TIA的患者（n = 106）进行评估，以确定牙周状况，并对其进行了为期24个月的随访，观察复发性血管事件（中风、心肌梗死和死亡）。通过经食管超声心动图评估AA的范围和其他斑块特征。
在我们的患者队列中，106名参与者中有27人在24个月的中位随访期内发生了复发性血管事件（包括16例中风或TIA）。重度PD与AA斑块厚度增加和钙化有关。结果表明，PD可能是AA的一个危险因素。在这个队列中，我们证实了重度AA与复发性血管事件之间的关联。
在中风或TIA患者中，重度PD与AA斑块厚度增加相关，这是复发性事件的一个危险因素。需要进一步研究来证实这一发现，并确定PD的治疗是否可以降低AA斑块进展率和复发性血管事件的发生率。
