Norhammar Anna, Näsman Per, Buhlin Kåre, de Faire Ulf, Ferrannini Giulia, Gustafsson Anders, Kjellström Barbro, Kvist Thomas, Jäghagen Eva Levring, Lindahl Bertil, Nygren Åke, Näslund Ulf, Svenungsson Elisabet, Klinge Björn, Rydén Lars
Department of Medicine K2, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden.
Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Clin Periodontol. 2025 Jan;52(1):16-23. doi: 10.1111/jcpe.14064. Epub 2024 Sep 11.
The study 'Periodontitis and Its Relation to Coronary Artery Disease' (PAROKRANK) reported an association between periodontitis (PD) and the first myocardial infarction (MI). This follow-up study aims to test the hypothesis that those with PD-compared to periodontally healthy individuals-are at increased risk for cardiovascular (CV) events and death.
A total of 1587 participants (age <75 years; females 19%) had a dental examination including panoramic radiographs between 2010 and 2014. PD was categorized as healthy (≥80% alveolar bone height), mild/moderate (79%-66%) or severe (<66%). A composite CV event (first of all-cause death, non-fatal MI or stroke and hospitalization following to heart failure) was investigated during a mean follow-up period of 9.9 years (range 0.2-12.5 years). Participants were divided into two groups: those with and without PD. The primary event rate, stratified by periodontal status at baseline, was calculated using the Kaplan-Meier method and Cox regression.
The number of events was 187 in the 985 periodontally healthy participants (19%) and 174 in the 602 participants with PD (29%; p < 0.0001). Those with PD had a higher likelihood for a future event (hazard ratio [HR] = 1.26; 95% CI: 1.01-1.57; p = 0.038), following adjustment for age, smoking and diabetes.
The PAROKRANK follow-up revealed that CV events were more common among participants with PD, which supports the assumption that there might be a direct relation between PD and CV disease.
“牙周炎及其与冠状动脉疾病的关系”（PAROKRANK）研究报告了牙周炎（PD）与首次心肌梗死（MI）之间的关联。这项随访研究旨在检验以下假设：与牙周健康个体相比，患有PD的个体发生心血管（CV）事件和死亡的风险增加。
2010年至2014年间，共有1587名参与者（年龄<75岁；女性占19%）接受了包括全景X线片在内的牙科检查。PD被分为健康（牙槽骨高度≥80%）、轻度/中度（79%-66%）或重度（<66%）。在平均9.9年（范围0.2-12.5年）的随访期内，对复合CV事件（首先是全因死亡、非致命性MI或中风以及心力衰竭后的住院治疗）进行了调查。参与者被分为两组：患有PD和未患有PD的人。使用Kaplan-Meier方法和Cox回归计算了按基线牙周状况分层的主要事件发生率。
985名牙周健康参与者中有187例发生事件（19%），602例患有PD的参与者中有174例发生事件（29%；p<0.0001）。在对年龄、吸烟和糖尿病进行调整后，患有PD的人未来发生事件的可能性更高（风险比[HR]=1.26；95%CI：1.01-1.57；p=0.038）。
PAROKRANK随访显示，CV事件在患有PD的参与者中更为常见，这支持了PD与CV疾病之间可能存在直接关系的假设。
