Mascari Rachel, Vezzeti Alexandra, Orofino Christine, Byrd Amanda, Hicklin David, Nichols Cynthia, Curtis James, Sen Souvik
Department of Neurology, University of South Carolina, USA.
Prisma Health Medical Group, Columbia, USA.
J Neurol Disord Stroke. 2021;8(1). Epub 2021 May 19.
We investigated whether periodontal disease is associated with specific stroke subtype.
This is a single-center cross-sectional study. Periodontal disease was assessed in stroke and transient ischemic attack patients. Strokes caused by large-artery atherosclerosis were classified as intracranial atherosclerosis or extracranial atherosclerosis as well as anterior or posterior circulation disease.
Consecutive patients (N=265) were enrolled (age 64 ± 12.8, 49% white, 46% black, and 56% male). A third (N=87) had moderately severe periodontal disease. Twenty percent (N=42) were strokes due to large-artery atherosclerosis. Large-artery strokes had a higher proportion of patients with periodontal disease than without periodontal disease (31% vs.16%, X p=0.01). There was also a higher proportion of patients with periodontal disease (12% vs. 5%) with stroke due to posterior circulation disease (crude odds ratio or OR 3.0, 95% CI 1.1-7.9, p=0.03), which persisted after adjustment for covariates (adjusted OR 3.1, 95% CI 1.04-9.1, p=0.004). Periodontal disease patients had a higher rate of large-artery stroke due to intracranial atherosclerosis compared to those without periodontal disease (20% vs. 8%; crude OR 2.6, 95% CI 1.3-5.6, p=0.01), and this association persisted after adjustment (adjusted OR 2.6, 95% CI 1.1-5.8, p=0.004).
We report a higher proportion of stroke due to large-artery atherosclerosis in patients with periodontal disease compared to those without periodontal disease. We report an independent association between periodontal disease and intracranial atherosclerosis, as well as between periodontal disease and posterior circulation disease.
我们研究了牙周疾病是否与特定的卒中亚型相关。
这是一项单中心横断面研究。对卒中患者和短暂性脑缺血发作患者的牙周疾病进行评估。由大动脉粥样硬化引起的卒中被分类为颅内动脉粥样硬化或颅外动脉粥样硬化，以及前循环或后循环疾病。
共纳入连续患者（N = 265）（年龄64±12.8岁，49%为白人，46%为黑人，56%为男性）。三分之一（N = 87）患有中度严重牙周疾病。20%（N = 42）为大动脉粥样硬化所致卒中。大动脉卒中患者中患有牙周疾病的比例高于未患牙周疾病的患者（31%对16%，X²p = 0.01）。后循环疾病所致卒中患者中患有牙周疾病的比例也更高（12%对5%）（粗比值比或OR 3.0，95%可信区间1.1 - 7.9，p = 0.03），在对协变量进行调整后该关联仍然存在（调整后OR 3.1，95%可信区间1.04 - 9.1，p = 0.004）。与未患牙周疾病的患者相比，牙周疾病患者因颅内动脉粥样硬化导致的大动脉卒中发生率更高（20%对8%；粗OR 2.6，95%可信区间1.3 - 5.6，p = 0.01），且在调整后该关联仍然存在（调整后OR 2.6，95%可信区间1.1 - 5.8，p = 0.004）。
我们报告，与未患牙周疾病的患者相比，牙周疾病患者因大动脉粥样硬化导致的卒中比例更高。我们报告了牙周疾病与颅内动脉粥样硬化之间以及牙周疾病与后循环疾病之间存在独立关联。
