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治疗牙周炎和首次心肌梗死后的再发事件:一项丹麦全国队列研究。

Treated periodontitis and recurrent events after first-time myocardial infarction: A Danish nationwide cohort study.

机构信息

Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.

Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.

出版信息

J Clin Periodontol. 2023 Oct;50(10):1305-1314. doi: 10.1111/jcpe.13853. Epub 2023 Jul 18.

Abstract

AIM

To investigate the association between previous periodontal treatment and recurrent events after first-time myocardial infarction (MI).

MATERIALS AND METHODS

From the Danish nationwide registries, patients with first-time MI between 2000 and 2015 were divided into three groups according to oral health care within 1 year prior to first-time MI. A multiple logistic regression model provided adjusted odds ratios (ORs) with 95% confidence intervals (CIs) to assess the 3-year risk of major adverse cardiovascular events (MACE).

RESULTS

A total of 103,949 patients were included. Patients with treated periodontitis (PD) prior to first-time MI had an adjusted 3-year risk of MACE similar to patients presumed periodontally healthy (OR 0.97 [95% CI 0.92-1.03]). Patients with no prior dental visits were significantly older, had more comorbidities and showed significantly increased adjusted 3-year risks of MACE (OR 1.47 [95% CI 1.42-1.52]), cardiovascular death (OR 1.71 [95% CI 1.64-1.78]) and heart failure (OR 1.13 [95% CI 1.07-1.20]) compared with patients presumed periodontally healthy.

CONCLUSIONS

Patients with treated PD 1 year prior to first-time MI had a similar risk of recurrent cardiovascular events as patients presumed periodontally healthy. No dental visit prior to first-time MI was an independent risk factor for recurrent events.

摘要

目的

探讨首次心肌梗死(MI)后牙周治疗与复发事件之间的关系。

材料和方法

根据丹麦全国性登记处的数据,将 2000 年至 2015 年间首次发生 MI 的患者根据首次 MI 前 1 年内的口腔保健情况分为三组。采用多因素逻辑回归模型提供调整后的优势比(OR)及其 95%置信区间(CI),以评估 3 年内主要不良心血管事件(MACE)的风险。

结果

共纳入 103949 例患者。与假定牙周健康的患者相比,在首次 MI 前患有治疗性牙周炎(PD)的患者发生 MACE 的 3 年风险调整后 OR 相似(0.97 [95%CI 0.92-1.03])。未进行过牙科就诊的患者年龄较大,合并症较多,且 MACE(OR 1.47 [95%CI 1.42-1.52])、心血管死亡(OR 1.71 [95%CI 1.64-1.78])和心力衰竭(OR 1.13 [95%CI 1.07-1.20])的调整后 3 年风险显著增加。

结论

在首次 MI 前 1 年患有治疗性 PD 的患者发生复发性心血管事件的风险与假定牙周健康的患者相似。首次 MI 前未进行牙科就诊是复发事件的独立危险因素。

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