Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, P.R. China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China.
J Periodontol. 2024 Feb;95(2):175-184. doi: 10.1002/JPER.23-0276. Epub 2023 Aug 3.
The association between periodontitis and cardiovascular disease (CVD) has been widely explored, but little is known about the effect of periodontitis on the mortality of CVD patients. This study aims to clarify the effect of periodontitis on all-cause and cause-specific mortality of CVD patients.
We included 2,135 individuals with CVD from the National Health and Nutrition Examination Survey. Mortality data were ascertained by linkage to National Death Index records through 31 December 2019. We used Cox proportional hazards models for all-cause mortality and competing risk models for CVD and cancer mortality to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Further covariate adjustments, stratification analyses, and a variety of sensitivity analyses were conducted to test the reliability and robustness of the results.
The all-cause mortality in CVD patients with moderate/severe periodontitis was significantly higher than in those with no/mild periodontitis (HR: 1.25; 95% CI: 1.02-1.52; P = 0.03). The all-cause mortality in participants with severe clinical attachment loss was significantly higher (HR: 1.07; 95% CI: 1.01-1.14; P = 0.01). However, no discrepancy in CVD or cancer mortality was observed between CVD patients with different periodontal status.
Our findings from a longitudinal study with a large sample indicated significant but slightly higher all-cause mortality in CVD patients with moderate/severe periodontitis than in those with no/mild periodontitis.
牙周炎与心血管疾病（CVD）之间的关联已得到广泛探讨，但对于牙周炎对 CVD 患者死亡率的影响知之甚少。本研究旨在阐明牙周炎对 CVD 患者全因和特定原因死亡率的影响。
我们纳入了来自全国健康与营养调查的 2135 名 CVD 患者。通过与国家死亡指数记录的链接，截至 2019 年 12 月 31 日确定死亡率数据。我们使用 Cox 比例风险模型进行全因死亡率分析和竞争风险模型进行 CVD 和癌症死亡率分析，以估计风险比（HR）和 95%置信区间（CI）。进一步进行了协变量调整、分层分析和各种敏感性分析，以检验结果的可靠性和稳健性。
中重度牙周炎的 CVD 患者的全因死亡率明显高于无/轻度牙周炎患者（HR：1.25；95%CI：1.02-1.52；P=0.03）。严重临床附着丧失患者的全因死亡率明显更高（HR：1.07；95%CI：1.01-1.14；P=0.01）。然而，不同牙周状况的 CVD 患者之间在 CVD 或癌症死亡率方面没有差异。
我们的这项大型纵向研究结果表明，中重度牙周炎的 CVD 患者的全因死亡率明显高于无/轻度牙周炎患者，但差异仅略有升高。
